If you are considering giving birth at home or in a birth center with the help of a midwife, you might be intrigued by the possibility of having skilled, personalized, hands-on care that can reduce the incidence of cesarean section, birth injury and trauma. While you might cringe at the thought of explaining your choice to your mother-in-law, you also might be concerned about the cost.
There are different types of midwives, and your costs will vary depending on which type you choose to hire, where you live and variations in individual prices. A certified nurse midwife, a registered nurse who has graduate-level midwifery training, is able to prescribe medications and may work with a doctor at the hospital. Similarly, certified midwives also write prescriptions and work in hospitals, though they are not registered nurses. Certified professional midwives, on the other hand, specialize in delivering babies in a birth center or at a client's home and cannot prescribe medication.
Nationwide, the cost of hiring a midwife varies greatly from approximately $1,500 to $5,000, with birth centers often charging a bit more than home-birth midwives. This flat fee usually covers all prenatal visits (which are on the same schedule as obstetrician visits), attendance at the labor and birth and several postpartum visits after the baby is born. Keep in mind that if you develop serious complications which compel you to give birth with a doctor, such as preeclampsia or premature labor, some or all of this fee may be non-refundable.
For an out-of-hospital birth attended by a midwife, you can expect some extra costs to crop up. If you need an ultrasound, you'll pay approximately $200 to $400 for that, unless it is covered by your insurance. Some midwives include more than others in their basic fees. Ask about labs, blood work and an inflatable birth tub. The largest potential expense comes in the event that there are complications at the birth that require you to transfer to a hospital. A C-section can set you back $25,000 or more if you are uninsured.
In the U.S., Medicaid must cover the cost of a birth attended by a nurse midwife. In 33 states, private insurance is also required to cover nurse midwives. If you are choosing a certified professional midwife or certified midwife, coverage will vary from insurer to insurer, and you'll need to inquire with yours directly. If you are looking at paying out of pocket for a midwife, creative financing could help. Some midwives are willing to barter with clients or set up an extended payment plan. Other expectant mothers have raised birth funds by asking for donations in lieu of baby shower gifts and hosting garage sales and fundraisers.