Hiring a Midwife: How Much Does Homebirth Cost?

Lets talk about finances! This is often the hot-button topic when we do consultations with clients seeking home birth midwives.

How much will it cost? Can I afford it? Is it worth the cost?

As midwives, we understand how complicated healthcare costs can be, and we strongly believe in transparency when it comes to the costs of your care.

At Wilder Midwifery, our fee for EVERYTHING (including prenatal, postpartum, and birth services - and often called a “global fee”) is $5000, which is significantly lower than the average hospital delivery! This is the average cost of homebirth midwifery in Oregon (ranging from $4000-$6000), though in other parts of the country this cost can vary substantially.

Below is a breakdown of what is included in your fee, as compared with a standard hospital delivery:

• This is based on an average, uncomplicated prenatal course and home birth.

• **This is based on the average cost of an uncomplicated, vaginal delivery in Oregon, based on a 2014 study via Scientific American: https://blogs.scientificamerican.com/sa-visual/the-cost-of-giving-birth-in-the-u-s/.

In Oregon, this breakdown is a pretty average comparison of the costs of home birth versus hospital birth care - for the same type of uncomplicated birth experience.

If you factor in the increased charge of receiving medications or interventions in labor when choosing a hospital birth (such as epidural anesthesia, or cesarean section) then the cost of hospital birth goes up significantly.

One of the most common reasons people end up choosing to birth in the hospital, even when they wanted a home birth, is that their insurance wouldn’t cover the costs.

This has always been interesting to us! Because even with insurance covering the costs of care at the hospital, often your out of pocket fees and co-pays add up to MORE than you would have spent out of pocket on a home birth midwife! So it might seem “cheaper” if insurance covers more of your care in hospital - when in actuality your out of pocket costs are increased.

Or, as Scientific American puts it:

“So, just how expensive is it? Despite the fact childbirth is one of the most common reasons for hospital admissions in the U.S., it can be difficult for an individual to estimate how much they might end up paying to deliver a baby. Part of the problem is charges vary based on factors such as hospital location, type of delivery and the payer. Depending on a person’s income and insurance status, this can be quite an anxiety-inducing question.”

We want to take the anxiety out of the equation and tell you your costs up front! When you come into our care, you know the maximum final amount you owe us, no matter what! No mystery about it.

So what does the global fee cover?

Below is a breakdown of everything the global fee covers, and everything it does not cover!

But what if you can’t pay out of pocket?

We get it. This is the biggest barrier to being able to afford a midwife, even if objectively the cost is “cheaper” than a hospital delivery. We want to make midwifery accessible for as many people as possible, while also making staying on call 24/7 sustainable and possible for us as midwives and breadwinners for our families.

In order to do this, we require just a 10% deposit on your birth when you book our services ($500). The rest of the fee is not due until 36 weeks in your pregnancy, when we actually go on call for you and your birth. This means you can make payments over the course of your pregnancy, or save up until 36 weeks to be able to afford the cost of care.

However, we understand that healthcare expenses can be challenging to pay off on a timeline. We are not able to offer financing, but we are happy to refer you to organizations that do: Both Care Credit and United Medical Credit are low-interest options to help you finance midwifery services. This lets you have the birth you want, while getting a little longer timeline with which to pay it off!

Insurance Coverage

Some insurances will not cover the costs for out of hospital birth. Others will, even if the providers are out of network. Wilder Midwifery does offer direct insurance billing and can also provide you with an itemized bill to submit to your insurance for reimbursement (if you prefer). In addition, we can accept payment from HSAs! This is not true across the board for all home birth practices across the country.

Medicaid Coverage

We are in the process of becoming medicaid (OHP) approved providers! Our hope is to be able to offer some of our monthly client spaces to those who have medicaid insurance. We will make an announcement once this process is completed!

Have questions about the costs of home birth? Shoot us a message or comment and we will get back to you!

Resources for more information:

• https://www.scientificamerican.com/article/the-u-s-needs-more-midwives-for-better-maternity-care/

• https://blogs.scientificamerican.com/sa-visual/the-cost-of-giving-birth-in-the-u-s/