Hiring a “solo” Midwife, pros and cons
Hiring a midwife is a big decision. When hiring a solo/private independently practicing midwife, you are entrusting one person with the most precious parts of your life. Hiring a private/solo Midwife has some amazing benefits and some challenges. Here are some of the pros and cons to inform families and help them make their best choices and find the right kind of care for each family.
Pros:
Hiring a private/solo Midwife means you’ll have a known entity at your birth. Your midwife will know your birth plan, your desires, and your health background. You’ll have had time in the course of your care to ask and know what your midwife will do and say during labor. You won’t have the anxiety of who will be on-call when you go into labor.
You’ll have human-human communication. With larger multi-midwife birth center practices/OB offices, you often have to go through several systems before being able to ask simple questions. Those questions can be missed, forgotten, or dismissed easily because they are so busy, this isn’t the case when you have a solo private midwife.
Your Midwife will have more time for you and your family. Private/solo Midwives take fewer clients to be optimally present. Your appointments are longer, more in-depth, and more informative. You don’t feel rushed.
Your solo/independent Midwife can customize your care. Because we work for ourselves and our clients, we have a greater degree of flexibility than large multi-midwife practices/birth center practices or OB offices.
You have more control over your quality of care. You can research a singular Midwife more easily than a large multi-midwife practice/birth center or OB office. Multi-midwife practices, birth centers, and OB offices can and do hire other practitioners at their will.
Your solo/independent Midwife is often better-rested, and more centered because of increased personal resources and better work-life balance. These factors support better care for clients.
Independant/solo Midwives are often more skilled Midwives. Birth Centers hire newer midwives (lower salary demands/higher overhead), which inherently means those Midwives have seen/done less Midwifery work. Independent/solo Midwives often opt to start practices for greater work/life balance and compensation but these solo/independent Midwives need to be more skilled to maintain a client base and have their clients have their best births.
Independant/solo practice Midwives are relationship-based vs. protocol-based.
Solo independent Midwives often see clients only in the client’s home, to keep overhead low and get to know families on a more personal level.
Solo/independent Midwives often loan out birth tubs. Birth Centers require purchase and breakdown by your family or support people.
Your Midwife is committed to attending your birth. By the time you are close to your birth, Your midwife is also excited to meet your baby with you!
Cons:
Private/solo Midwives do not accept insurance. Most private Midwives provide a superbill to clients and have the client work directly with their insurance to get reimbursed. Illuminated Midwifery works with a third-party biller to help clients get reimbursed (see https://www.illuminatedmidwifery.com/midwiferyinfotoknow/thirdpartybilling) Most birth centers accept some insurance. Most OB offices accept most insurance. Very few Midwifery practices accept Medicaid.
Baby birthdays can overlap. Most solo Midwives limit the number of clients they take in any particular four to six-week range to avoid this, but, overlapping labors/births aren’t impossible. This means solo Midwives need to have solid Midwifery backups which they hope to never use.
Solo/Independent Midwives are one human, which means there can be occasions when they wouldn’t be their best selves to attend to you/your needs. Your solo Midwife will need to recover after a long birth which may mean slower response times or only responding to labor/emergency needs.
With a solo practitioner Midwife, you are only receiving one kind of information. In larger practices, you can see multiple midwives and potentially get different types of information (I consider this a benefit if you enjoy your particular private/solo Midwife).
Solo Midwives may ask you to invest in additional resources/tools/services/time (again based on experience of caring for folks) based on your personal needs. Birth centers/multi-midwife practices/OBs may not do this. Examples of the additional items may be: Comprehensive Childbirth education, doula support, and lactation support. Sometimes these resources are cost-based.
With a solo Midwife, you are relying on your Midwife to be honest, skilled, a good communicator and an overall good care provider. It may not be as evident that this Midwife isn’t those things if you can’t see multiple kinds of care (as you would in multi-midwife practices).
