White Oak Midwifery Service

Fee Schedule

My fees for all of your prenatal, birth, and postpartum care, including six weeks of well-baby care after the birth, are $3775 if you live in the Bloomington area and $4275 for all others. (The discrepancy reflects the difference in costs to me for my assistant’s fee and the travel time for all your in-home prenatal and postpartum care.) Your other expenses will include the price of the birth kit (approximately $100-125), your baby’s newborn screen lab fee ($120), and whatever lab work and appointments arise from you relationship with your medical back-up. Some or all of the latter should be covered by insurance, Medicaid, or the Healthy Indiana Program (HIP). Some of my clients choose to purchase or rent birth pools to labor and/or deliver in, and the current rental fee is $200 for my EcoBirth inflatable pool, available on a first-come, first-serve basis.

Once you have hired me to attend your birth, I would like you to make a $300 deposit at the first prenatal visit, along with a manageable plan for paying me, and to let me know what that plan is. The majority of my clients pay me over time, which is just fine. Ideally the fee should be paid in full by the time of the birth, unless we have an explicit plan for payment over a longer, specified period. Of greater importance to me is that the clear communication and trust that we are establishing throughout our relationship continue into our financial dealings. I can be very flexible about money matters as long as you are being clear with me. My ultimate goals are for this to be affordable for you, and for me to not have to play “bill collector” long after your baby’s birth. That’s no fun for either of us. After some disappointing, costly experiences in the last couple of years, I am unable to be on call for births where a substantial portion of the fee remains unpaid without a realistic plan for the debt’s resolution.

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 homebirth 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 homebirth 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?”

  1. 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.
  2. 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 $125-150 (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.
  3. 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 $125-150 for each prenatal visit we have had, excluding our initial consultation. If you leave my care electively after 32 weeks of pregnancy, I retain $600 ($1,200 out-of-town) plus the prenatal costs.
  4. 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.
  5. 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.
  6. Payment methods
    You can pay me by check, cash, PayPal (mhayres2@yahoo.com) or Venmo (@MaryHelen-Ayres). If you have an HSA, you can direct them to send me payments via check.

Please talk to me if you have questions about these policies!