Home Birth Price
Sliding Scale Fee Sheet
As for home birth price, beginning in 2024 I am offering a sliding scale for my fees, attempting to balance the high costs of practicing with the economic realities of young families. As you read through the tier system below, understand that I am not going to question you about your income. A midwife-client relationship is rooted in mutual trust, and I trust you to choose the proper tier for your fee.
The first two tiers have a local/out-of-town fee, because I do all of my clients’ care in their homes. I define local as anywhere in Monroe County plus the town of Nashville, but not rural Brown County. Let me know if you have questions about this.
The fee covers all of my care during the pregnancy, birth, and postpartum period, including six weeks of well-baby care. Your extra expenses include the disposable kit of birth supplies, which you will order and customize according to your wishes ($100-125), and the lab fee for the baby’s newborn screen ($120). Lab work and ultrasounds are not included in my fee.
Tier 1
This would be the standard fee for everyone if there were no need for a sliding scale. It supports the actual cost of practicing midwifery. If you have financial security such that your basic needs and many of your wants are covered, this is your fee.
$4775/5275
Tier 2
This tier fits people for whom paying the full fee would make my care unaffordable. Income is steady, but the budget is very tight. Basic needs are met, but most wants have to wait until life is more debt free, savings are built, and you’re not living paycheck to paycheck.
$4275/4775
Tier 3
This is for people who really need a steeply discounted fee to afford my care. They struggle to keep up with the cost of basic necessities, but consider home birth services so important that they will sacrifice to make it happen. I can only offer a limited number of these fees in any one year, and do so only for local clients.
$3775
Discounts
Tiers 1 & 2 receive a $250 discount if the fee is paid in full by 32 weeks. Returning tier 1 & 2 clients in 2024 and 2025 will receive an additional $250 discount to offset the sticker shock. All fees must be paid in full by our 36-37 week home visit, unless you have made other, solid arrangements with me. Some clients might want to consider using Med Loan Financing to take advantage of discounts and space payment out over a longer period of time. I can be flexible with financial matters, but really hate having to play bill collector: please do not put me in that position.
How to Pay the Fee
I will ask at our initial consultation how you would like to spread out your payments, so be prepared for that question. Whatever you plan, I would also like to collect a $300 deposit at our first prenatal visit to secure your spot in my calendar. The following methods of payment work: cash/check/PayPal/Venmo/ Zelle. If you intend to use HSA/FSA funds but only have a debit card, you can direct those funds to pay me by check.
Regarding Insurance
Some of my clients who have private insurance have successfully filed claims to recover some or most of my fee after they have paid it, and after their babies are born. Certain private, Christian share-type companies reimburse readily for all home birth services; with the more mainstream companies, reimbursement is unpredictable and will not be 100%. I don’t deal directly with my clients’ insurance companies but am happy to give you a detailed receipt that you can use to file your claim. Because we cannot count on mainstream companies for reimbursement, you need to plan to pay the fee to me, and then use my receipt to direct the companies to reimburse you. All fees associated with a home birth are eligible for payments out of health savings accounts (HSAs), flex savings accounts (FSAs), and the like. Unfortunately – and unfairly – licensed certified professional midwives (CPMs) in Indiana are not covered by either Medicaid or the Healthy Indiana Plan (HIP).
A Few “What ifs?”
- What if you need to transport to the hospital during your birth?
I help arrange for that, stay with you continuously to help with labor support and communication in the hospital, continue with postpartum care for you and your baby after you’re discharged, and my fee remains the same. - What if a complication arises in the pregnancy and you need to transfer your primary care to a physician and plan a hospital birth?
Before 32-weeks I retain the $300 deposit and $150-175 (local vs. out of town) for each prenatal visit we have had, excluding our initial consultation, if you are making an absolute transfer of care out of my practice; after 32 weeks I retain $600 local ($1200 out of town) plus the prenatal visits. On the other hand, if you still wanted me to remain involved, continuing midwifery care and attending your hospital birth to provide labor support, followed by the usual six weeks of postpartum care to both you and your baby, my fee usually remains the same. - What if you simply change your mind about working with me?
Prior to 32 weeks of pregnancy, I retain a $300 deposit and charge you $150-175 for each prenatal visit we have had, excluding our initial consultation. If you choose to leave my care after 32 weeks of pregnancy, I retain $600 ($1,200 out-of-town) plus the prenatal costs. - What if two births are happening at once and I have to call in a back-up midwife to cover for me until I can arrive?
I will take care of compensating her out of the fee you have already paid me. You will not have extra expenses. - What if you don’t hire me until near the end of the pregnancy?
The fee remains the same. Although we will have missed a certain number of prenatals together, that just means I have to play catch-up to you and your pregnancy, and do more follow-up with you afterward, than if we had been working together all along. My tasks aren’t really lessened so much as compressed. And what the fee covers, more than anything else, is the responsibility I assume in becoming your caregiver and attending the birth itself. It’s hard to put a dollar amount on that, but building our relationship while doing prenatal care over the course of the entire pregnancy makes the work easier, overall.