Interest in care provided by midwives, which focuses on wellness and natural processes, has been steadily rising across the state. The cost to hire a midwife is not a single fixed number; rather, it is highly variable and depends on a multitude of factors specific to the care provider and the planned setting for the birth.
Cost Variation by Midwife Type and Setting
The cost of midwifery care in Florida is largely dictated by the professional certification of the provider and the intended location of the delivery. Certified Nurse Midwives (CNMs) are registered nurses who have completed graduate-level education and are licensed medical professionals, often practicing within hospital systems or integrated birth centers. Care provided by CNMs in these settings is typically billed similarly to physician services, and the cost to the patient is primarily determined by their insurance plan’s deductible and co-payments.
Licensed Midwives (LMs) and Certified Professional Midwives (CPMs) primarily offer out-of-hospital births in licensed birth centers or in the client’s home. The typical “global fee” for a home birth with an LM/CPM in Central Florida can range from approximately $7,000 to $10,000, which includes care from the initial prenatal visit through the postpartum period. A birth center delivery with an LM/CPM may have a comparable midwifery fee, often around $6,000 to $6,500, with an additional facility fee charged separately. For clients seeking personalized prenatal care from a midwife but planning a hospital delivery, the cost for the midwife’s services may be lower, sometimes around $4,500.
The difference in cost ranges reflects the service model and overhead for each setting. CNMs practicing in hospitals are part of a larger medical system, where the hospital bills for the facility, equipment, and staff separately. Conversely, LMs and CPMs providing home or birth center care often include most of their professional services into a single package price, which covers their on-call time and the necessary supplies for an out-of-hospital birth.
Typical Comprehensive Fee Structure
The “Global Fee” or “Package Price” model is typically used by LMs and CPMs practicing out of the hospital. This comprehensive fee for a low-risk pregnancy includes:
- All routine prenatal visits, which are often longer and more personalized than standard obstetric appointments.
- The midwife’s professional services during the labor and delivery, including 24/7 on-call availability leading up to the due date, and the presence of a birth assistant.
- Postpartum care, typically involving multiple home or office visits in the days and weeks following the birth to monitor the health of both the mother and the newborn.
- Support services such as breastfeeding support and newborn screenings.
- Specific services like the filing of the birth certificate and metabolic screening of the newborn.
Navigating Insurance Coverage and Self-Pay
Florida law mandates that most group health insurance policies that provide maternity coverage must include the services of both Certified Nurse Midwives and Licensed Midwives, as well as licensed birth centers. Despite this legal requirement, the practical application of coverage varies significantly, largely depending on the midwife’s certification and their network status. CNMs are typically covered by both private insurance and Medicaid, often being in-network with major carriers, because they are viewed similarly to other hospital-based medical providers.
LMs and CPMs, particularly those attending home births, often face a more complicated financial process. While the law requires coverage, many independent LMs and CPMs are considered out-of-network, or they may choose not to contract with insurance companies due to low reimbursement rates. In these situations, the patient usually pays the global fee directly to the midwife by a certain point in the pregnancy, often by 36 weeks. The family is then provided with a detailed bill to submit to their insurance provider for direct reimbursement.
Many midwives offer payment plans to spread the cost over the duration of the pregnancy. Florida Medicaid does cover some Licensed Midwives and birth centers, but the acceptance of Medicaid clients may be limited by individual practices due to the low reimbursement rates.
Unexpected or Excluded Expenses
While the global fee covers the midwife’s primary professional services, several common costs are typically excluded and will require separate payment, regardless of the setting. The most frequent excluded expenses are those billed by third-party providers:
- Laboratory fees for blood work and genetic screening tests performed throughout the pregnancy.
- Ultrasounds, which are billed separately by the imaging facility or radiologist.
- A birth kit, which contains necessary disposable supplies for the labor and delivery.
- Any required pharmaceuticals, such as RhoGAM injections for Rh-negative mothers.
- A separate facility fee if the birth takes place in a licensed birth center, covering the use of the space, equipment, and non-midwife staff.
- Any facility fees, physician costs, or other medical expenses incurred at the hospital if a medical transfer becomes necessary during labor.