Appointment Guide

Some people think independent midwives are rather expensive. I can only assume these people are either unaware of how comprehensive a midwifery service is or have never tried examining the service and working out an hourly rate.

I always carry this time sheet with me to give an example of how much time I spend with a typical client. As every client is individual the figures are of course only a guideline, particularly the birth and immediate postnatal care. For example there have been many occasions where a birth has progressed quite slowly, sometimes for over 24 hours from when I first arrived. Also some clients might need longer and more frequent follow ups to assist with postnatal problems and breast feeding.

Period	Visits	Visit Hrs	Total Hrs	Total Hrs + Travel*
Initial visit	1	2	2	3
Prenatal Months 3-5	3	2	6	9
Prenatal Months 6-8	6	2	12	18
Prenatal Month 9	4	2	8	12
Birth	1	12	12	13
Postnatal Day 1	1	4	4	5
Postnatal Days 2-7	6	2.5	15	21
Postnatal Week 2	3	2	6	9
Postnatal Weeks 3-6	4	2	8	12
Telephone			?	?
Totals	29		73	102

* Assumes 30 minutes travel time to and from appointment.

If I charged by the hour it could be an financial lottery for many clients. But nobody should be clock watching during the birth of their child or feel they cannot afford good postnatal care. I want to provide the same level of service to all my clients so a simple fixed fee is my preferred approach, even though it is not the most financially advantageous.

As you can see; to provide this level of care it's simply impossible to take on very many clients. Typically a maximum of 3 or 4 per month. You certainly won't see a midwife with an obstetrician's workload, which can be anything between 25-50 births per month. Then again you won't see many midwives driving a Mercedes or Ferrari. Midwives only do this because they are passionate about birth and not simply passionate about opening your wallet.