How much do midwives cost in the United States?

November 11 | Guest post by Therese Charvet
@offbeathome runs these advice questions as an opportunity for our readers to share personal experiences and anecdotes. Readers are responsible for doing their own research before following any advice given here... or anywhere else on the web, for that matter.
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Thanks to Jennifer Longaway for submitting this photo to the Offbeat Mama pool!
How much do midwives generally charge for their services? My husband and I both have jobs with crummy insurance (What? In the United States? Shocker), and I'm a little worried about the cost of birthing a baby in a hospital. Do midwives offer payment plans, like I'm currently making on my couch? -Eliza


Midwives, especially when they offer home-births, are about half or even a third of the cost of a doctor-hospital birth option. Birth Center births are more expensive than home birth because of the cost of outfitting and running the center, but generally less than hospital stay.

The cost of the midwives services are generally lower than a physician, depending on the place, educational background and context for the midwifery practice. I’m sure some midwives do payment plans, especially since pregnancy itself is a 9 month process. You might want to read about this Seattle couple who are working out a payment plan with their midwife.

But these are generalizations; you’ll need to shop around and see what your local options are. GOOD LUCK!

If you've got a non-medical question to Ask the Midwife, you can click here to email Therese. She'll select a question every couple weeks to answer on the site. Remember, if you've got medical questions, you need to contact your care provider!

  1. my birthing center (in SW florida) charges a $5,000 flat fee for a center or home birth and all prenatal and postnatal care – about half the cost of a hospital birth and 1/3 the cost of a c-section which you are more likely to have in a hospital setting. additional costs include initial and 26-28 week blood labs and a birthing kit (all the supplies needed for a center or home birth). you can also choose to have and pay for ultrasound(s) and doula services. total cost for everything (including one ultrasound and doula services) would be about $6,500.

    thankfully i have really, really good insurance through my employer – i was offered the job the same day i found out i was pregnant – so the midwife services will cost about $1,600 and i have until week 32 to pay that off in whatever way i'm comfortable with.

    if paying cash only (which i'd planned to do before getting insurance) there is an initial discount of 20% off the top and then additional discounts based on how fast you pay down the balance. this particular birthing center also takes medicaid and will help women through the application process.

    i knew midwifery care was the way i wanted to go long before i got pregnant and that i would have paid MORE than a hospital birth to get the control and personal autonomy that comes with this kind of care. i've not been pressured to do anything except what's right for me. my first visit with my midwife was 3 hours, most of it spent talking, and my partner was right there with me. if something doesn't feel right and i need to see my midwife, she's a phone call away and will drop everything to meet me for an exam or just to chat. the birthing center serves as a hang out space, library, resource hub, etc. i will get extensive childbirth education through a series of classes offered at the center. there is postnatal care including home visits, breastfeeding support, baby wearing instruction, etc. it's all included in the experience. these are things you just can't get at a regular ObGYN and they are worth every penny and then some.

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    • Do you have the name of this midwife center and midwife? I too live in SW florida and am looking desperately for a midwife and natural approach. I also have medicaid..would they take it?

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    • Please, I want an affordable Midwife that also agrees with me that Birth is Natural NOT a medical procedure.
      Please tell me the name of this Midwife in SW Florida that only charges up to 6,500!
      I really want to talk to her!!!

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  2. If you're not set on a home birth, try looking for a midwife/nurse practioner who works with a doctor. My ob/gyn had two who worked in his office and I could have gone with either of them and still had my pregnancy costs covered by my insurance. As for what your insurance covers, check around because some states require that insurance cover all pregnancy costs (doctor visits, tests, and hospital stay). In my case, my only out of pocket cost was a $15 copay for my doctor visits.

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  3. I'm in illinois, where it's extremely difficult to find midwives and impossible to have a midwife attended home birth. I've found one of the few midwife organizations in the area which operates out of a hospital alternative birthing center and it looks like my costs are going to be somewhere right over $6000. The hospital fees are about half of that, so you can really see where having a home birth would lower the cost. Still, the midwives I've met here are amazing and open to payment plans and even discount everything if you can pay on time with cash!

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  4. My homebirth midwife charged $2,000 here in Memphis TN, which we had paid by the 32nd week, and since things did not go as planned (a longish sad story), she gave us a partial refund. This was back in 2005, so prices may be somewhat different now.

    You may want to also check if you would qualify for Medicaid – here in TN ANY woman who is pregnant automatically qualifies for it. I had my own excellent insurance, so I didn't explore this option in detail, but it could be worth looking into, especially in case anything goes wrong (I don't want to be a downer, but I know first-hand that unfortunately things can go really wrong). For me, the difference in having insurance that covered almost everything was about $30,000.

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  5. In 2008 my Portland, OR midwife charged $2,500 for our homebirth, paid by the 36th week. She accepted pretty much any payment method, but we paid by CC in installments ($500 here, $1000 there, as we repaid the CC). Her services included being on-call 24/7, regular pre-natal visits, advise about anything and everything, and access to her library (research about vaccination, etc.), and a tub for a home-water-birth, if desired. She was amazing and I'm definitely planning on contacting her again, if/when I get pregnant again.

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  6. When I read this at first I thought it was a joke! I forget that it cost's in America – in England it's 'free' on the National Health Service!!! I think i'd have a heart attack if someone tried to charge me!

    (well, it's covered by our taxes, but it seems free)

    • That's fantastic. I'm American, marrying an English bloke next year, and I hope we'll be in England by the time kids come along. Since I definitely want to go the midwife route, that's good to hear.

      • Me too Anna. I think in NZ we take for granted the fact that you don't pay for your pregnancy costs. It just seems so strange to pay for it. What happens if you can't afford it?

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        • In Canada our health care is covered too but midwives only started being covered as part of the basic health care costs in my province last year (Alberta). I think some other provinces covered it earlier, but others still don't cover midwives. A doctor-hospital birth is your only guaranteed coverage. Even with midwives being covered now, home or hospital are the only places you can be covered by healthcare. There is only 1 birth centre in the southern half of the province and its an extra cost not covered.

          Its staggering to think about how much the mainstream medical community feels that they should be allowed to charge for delivering a healthy baby on the mother's terms.

        • There are government assistance programs here in the US that a pregnant woman can sign up for to help cover costs. But the sad reality is that they don't always provide very extensive coverage and if you have a complicated pregnancy or birth, it could load you down with a ton of debt.

        • In my experience, you kind of wing it…there's sometimes medically indigent programs for the most basic of care, there's credit cards, there's bankruptcy, sometimes a midwife will exchange services( depending on what you do for a living). You have trouble getting a doctor to take you as a patient, sometimes you fall through the cracks. Hospitals are required by law to treat anyone who needs it, so worst case you show up at a hospital in labor without having any prenatal care and deliver. They discharge you ASAP and send you a bill, which you pay.

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  7. We are using a midwife group that works within an OB/GYN group. They only deliver at their university women's hospital. I had no interest in a home birth because we have 3 cats, and felt like we could never get the place clean enough for it. But also because if there was an emergency, the last place we wanted to be forced to go to is the hospital closest to us. The hospital where we're delivering does offer tub labor/birth although it is on a first come first serve basis (they only have 2 I believe). I like the fact that I'm able to get the best of both worlds. The midwives have assured us that we get to fully control our experience and provided things go well, we won't have any Dr.s involved at all. We're also lucky that our insurance covers it all so that made the choice even easier.

  8. ditto the above! love that socialised healthcare.

  9. I was so worried about paying for a midwife if I became pregnant, since up here in Canada it would have been an unnecessary expense. Then it became covered under health care! However, I still may have to pay for it because there is a shortage in our province so I might go down to the states to stay with family the last few months of my pregnancy in order to get the homebirth I desire.

    • Are you in Alberta too? I found out in early pregnancy that I would not make it on the list for midwives because there are so few in the city. I'm happy they are covered now! But I couldn't afford to go to the states and pay for it all.

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  10. My midwife was free as was all my maternity care. One good thing about socialized medicine.

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  11. We were disappointed to find that our insurance, which claimed to "cover midwives from an approved list", did not approve any midwives in our area when we had our son. I have since talked to other moms who said their insurance played the same game- claiming to cover midwife services or birth centers, just "none in your area," even though we've lived in two cities with plenty of non-hospital birthing options. I don't know if this is a common occurrence but its interesting to look into.

  12. I'm in the UK. Midwives cost nothing on the NHS.

  13. My limited experience thus far seems to indicate that around San Francisco it seems to be around 4000-6000 for pre/postnatal care and birthing. I've also seen many midwives offer payment plans as well. Good luck!

  14. In NYS, all insurance companies are required to cover the cost of a midwife and a home birth. Some companies require more hoops to jump through than others, but it's a state law. You just have to exercise your option. What state are you in?

    Also, I would check out your tribe on mothering.com and ask for advice about midwives that are open to payment plans, etc.

      • Yeah, it's pretty awesome. I found this out from a woman in my neighborhood who'd had a homebirth. And bonus for me, my insurance company happens to one of the better ones in terms of being being pro-MW and pro-HB! (Oxford, in case anyone was wondering–if you have Oxford, you just ask for an "out of network exception" and some other stuff.)

  15. i'd talk to you local midwives. they'll be very understanding about your questions. our homebirth midwife has a birth fee of $2000. now she is a traveling midwife who lives in another state then i do so each prenatal visit is $50…BUT if a few of us moms who are using her get together at one persons house that $50 is split between us all. midwives are very relaxed. she's never asked us for a dime yet, but the 2K is due on birthday. she told us upfront if that would be a prob to talk with her and we'd figure something out. GOOD LUCK! homebirths ROCK!

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    • Amber,
      I am not pregnant yet, we are planning to get pregnant in late May, this will be my first child and I have my heart set on a home birth. Is there any way to get the contact information for the midwife you used? She sounds great already. Thank you so much for your time.

  16. My homebirth with a midwife in Seattle was $2500, and that also includes all my maternity care (minus ultrasound and tests). It was a wonderful experience, but you need to think about what you are most comfortable with, as well as what you can afford.

  17. My homebirth midwife charged $2000 for everything, but I worked out a deal with her where I paid part of it by cooking some freezer meals for her. 😀 That's one great thing about HB MWs… imagine asking an OB if you could pay him with food!!

    • Amanda,
      I am not pregnant yet, we are planning to get pregnant in late May, this will be my first child and I have my heart set on a home birth. Is there any way to get the contact information for the midwife you used? She sounds great already. Thank you so much for your time.

  18. I looked at medicaid for pregnancy and found out that that program and Kid Care both haven't been paying for services used. The midwives I go to couldn't afford to keep covering people themselves when they had medicaid or kid care so they had to stop taking it. I'd definitely look into it if you don't have insurance, but it might be hard to find people who take it depending on what state you're in…

  19. Thankfully any sort of setup, may it be a hospital, birthing center or- home birth is free of charge here in Germany inlcuding the pre and post visits of midwifes etc.

    I decided to go for a midwife-only hospital birth. Which means I will be in the hospital with a connected childrens clinic, but I will only see 2 midwifes during the entire stay pre, during and post birth. no doctors needed.

    in case something goes wrong (no it won't – knock on wood) with me or the child during birth, there is always the option to have the midwifes call a doctor, or have the doctors from the childrens clinic come over.

  20. That's it! I'm officially moving out of the US! Sounds like everyone from abroad and Canada have much better healthcare. Con: being away from family. Pro: not being in debt up to my eyeballs for having a baby

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  21. That is one thing I am learning as I talk to friends in other countries as they have children. Most of them their birthing and such is covered, and some even get paid, longer maternity leave. I really wish the US would get on the band wagon with that one. Most young women working low end jobs are having to return within a month or so of giving birth just to be able to make the bills, or due to their jobs threatening them. It's a sad state of affairs.

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  22. or you could move to canada where midwives are paid for by our nationalized health care. having a baby here costs exactly $0.00. imagine the relief from knowing that bringing your child into this world will cost you absolutely nothing, even when there are complications that need more attention. i really hope that the US finally adopts some form of health plan one day. it's astonishing that the richest and most powerful country in the world can't seem to take care of its own.

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    • ^Just a note- healthcare up here is not Nationalized, its provincial. And not all provinces cover midwives (although its getting better). And even fewer help cover the costs of birth centres. Its getting better, but there are still far too few midwives available!

  23. Alright American offbeat mamas here's something that will really cook your noodle. As a New Zealander I qualified for free maternity care in New Zealand but when I was in Australia and had problems with my pregnancy I also got free healthcare thanks to a reciprocal arrangement with our government. I would also qualify for free maternity care on the NHS if I spent 2 years in Britain.

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  24. We paid $2500 here in Nashville, which was the no insurance discount. She did give us payment options, and we ended up not paying a dime until I got my tax return 2 months before I gave birth.

  25. It does sometimes terrify me reading about American healthcare. I am so intensely grateful to live in a country with nationalised healthcare.

    I live with the depressing fear that I may already be infertile as a 25 year old, but I know that I'm already on a priority list for free fertility treatment and that I will (hopefully) not have to pay a single penny in medical bills to bring a child into the world and that is a great comfort

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  26. I am in Boulder, CO and the home birth midwives I interviewed were between $3000 and $3400. I ended up going with a midwife with 14 years experience who provides all the prenatal care minus any specialized tests, birth assistance, and post-partum care for $3200. My insurance does not cover her in-network so I will pay 30% of the cost. She also has a biller that works with insurance so I will see if her biller pre-approves my insurance so that I will only pay that 30% vs. paying it all by 36 weeks and waiting for a discount. I will also pay $275 to attend birth classes led my my midwife and about $70 in supplies to have at home for the birth.

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  27. My midwife is charging me $2,600 total for all prenatal and postnatal care and the entire cost of the birth. I have to pay and extra $100 for the home birth kit and another $100 for the birthing pool, so all together it is $2,800.

  28. We planned a homebirth with a midwife. It was $4,500 for all our in-home prenatal visits, her time from early labor through three hours after babe arrived, and then seven in-home post-partum visits.

    We ended up with a hospital c-section. It was $85,000 (before insurance) for the five night stay, anesthesiology, OBs, and nursing support. I think we ended up paying about $1,700 after insurance.

  29. Does anyone know a good midwife near Monterey CA who will do a homebirth? I am moving cross country in my 6th month (FEB)and will have most of the tests and such covered by insurance and am looking for care for just the last trimester and delivery.

  30. Here in Oregon you could have a free birth if you wanted to. First of all, in every Oregon hospital it is required that we give you the same care as we would a paying patient.If you come in to have a baby you will receive the same services and care as the paying patient. If you qualify for Oregon health plan than it is partially covered and the hospital usually "eats" the rest of the costs. I am a labor and lactation nurse in Oregon. So some members of our state end up with free health care. No one goes uncared for.

  31. Socialized healthcare is not free. We pay for it with higher taxes and we are unable to choose what our taxes are spent on.

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