Does Insurance Cover Midwife Care?
Key takeaways:
A midwife is a medical professional who has the training and education to provide care to people throughout pregnancy, childbirth, and postpartum recovery. A certified nurse-midwife has the highest level of credentials and can write prescriptions for certain medications. There are also certified midwives and certified professional midwives.
A midwife can perform services in hospitals, clinics, birthing centers, or homes. Depending on their scope of training and practice, a midwife can provide primary care and family planning services for patients from adolescence to beyond menopause.
Most insurance plans cover midwife care, but benefits vary. Your health plan’s coverage typically depends on the type of midwife performing the services, their scope of practice, and where you receive the services.
Table of contents
A midwife is a person who has attained midwifery credentials. This education and training allows midwives to provide care and support for childbearers, mothers, and infants throughout pregnancy, childbirth, and postpartum recovery.
There are several types of midwives:
Certified midwife (CM)
Certified nurse-midwife (CNM)
Certified professional midwife (CPM)
Lay midwife
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CNMs are registered nurses. Both CNMs and CMs have graduate-level degrees in midwifery. CPMs must pass a national certification exam with training from an apprenticeship or an accredited program.
CNMs can write prescriptions for certain medications in every U.S. jurisdiction, and CMs can do so in a few states. CPMs are not able to prescribe medications.
CMs and CNMs typically attend births in hospitals, while CPMs primarily work in birthing centers and with home births.
Lay midwives learn the skill through apprenticeship and sometimes descend from generations of people experienced in assisting with pregnancy and birth — but they typically don’t have formal credentials, such as college degrees, certifications, or licensing.
Most insurance — including Medicare, Medicaid, Tricare, and private plans — covers midwife care from credentialed professionals.
What services does a midwife provide?
Many midwives focus on a holistic approach to pregnancy and birth anchored in the belief that these are natural processes that don't need medical interference, as long as there are no complications.
Midwives cannot perform cesarean section delivery (C-section) or epidurals. For example, to manage pain during labor, a midwife may offer non-medical methods such as hot and cold compresses, immersion in water, showers, and massages.
According to the General Accounting Office, 12 percent of U.S. births in 2021 were attended by a midwife.
Midwives provide individual care during pregnancy and childbirth that includes:
Offering health counseling and education
Helping with creating birth plans
Attending and leading births
Monitoring for possible complications in childbearers
Transferring care to another medical professional if the complication or emergency is outside of their practice
CNMs and CMs can also provide primary gynecological care and family planning services across the lifespan.
How much does midwife care cost?
According to MDsave — a price-shopping tool for uninsured people and people with high-deductible health plans — the estimated national average for a vaginal delivery with a midwife costs $7,419. This price doesn’t include prenatal and postnatal visits.
Midwife flat rates can range from $3,000 to $9,000 for prenatal, birth, postpartum, and newborn care services. Those fees usually don’t include lab tests and birthing supplies.
Flat rates or all-inclusive packages may require private pay outside of insurance. For instance, Redwood Midwifery charges a discounted package fee of $8,500 for comprehensive midwifery care and home birth at the time this article was published. This practice’s fee page notes that services billed to insurance separately could add up to $10,000 to $25,000 — but this is typically not your out-of-pocket cost.
Without insurance, the costs can vary based on many factors, including your midwife’s credentials and your birthing location. Home birth is typically less costly than hospital delivery.
Does health insurance cover midwife care?
Most employer health insurance plans and those available on Affordable Care Act marketplaces cover the minimal essential health benefits and include pregnancy and childbirth services.
In 2021, about 52% of U.S. births attended by CNMs or CMs were paid for by private insurance plans, and nearly all of those deliveries were in hospitals. Private insurance paid for fewer than 20% of births attended by midwives with other credentials, but 61% of those deliveries were at home and another 21% were in birthing centers.
Insurance plans that cover midwife care include:
Medicaid: Medicaid coverage for midwife care can vary depending on where you live, as well as the midwife’s scope of practice and licensing. Your state or territory Medicaid program covers CNM services but may not cover services provided by a CM or CPM. Birthing center services must be covered by Medicaid, but the same may not apply to home births.
Medicare: Medicare Part B reimburses CNM services at 100% of the physician fee for the same service that would be paid if furnished by a physician.
Medicare Advantage: These private Medicare plans cover the same services as original Medicare and may offer additional midwife care benefits.
Private healthcare plans: CNM services are covered by most private health insurance plans — and some cover CM and CPM care. Contact your health plan to determine benefits and which providers are in-network and out-of-network.
Tricare: Tricare covers midwife services provided by a CNM who is certified by the American Midwifery Certification Board and is licensed, in states where required. Midwife services by a registered nurse who isn’t a CNM may be allowed with a physician’s referral or supervision. Tricare doesn’t cover midwife services from a CM, CPM, or lay midwife. And home births usually aren’t covered when you live overseas.
Which is more affordable: Midwife care or traditional obstetric care?
The cost of midwife care versus traditional obstetric care for individuals depends on your insurance coverage and what’s available in your area.
Traditional obstetric care costs more because birthing services are typically provided by physicians in a hospital setting.
Peer-reviewed studies on the cost of midwife care versus traditional obstetric care show lower costs for midwives attending births.
A comparative study of low-risk U.S. births published in 2020 found that average costs were nearly $2,300 less for midwife-led care versus care led by obstetricians — with similar birth outcomes. A prediction model using the same data estimated that using midwives more broadly would lead to fewer preterm births and neonatal deaths, which would reduce the high costs of neonatal intensive care, among other savings.
What resources can help you pay for midwife care?
Many midwives offer advance payment plans for their care and services, because the cost typically must be paid in full before delivery. You may have to pay out of pocket even if you have insurance that reimburses you later.
Here are some ways to pay for your midwife care:
Save money ahead of time
Add cash gifts for midwife care to your baby registry
Choose an insurance plan that includes midwife care
Review insurance benefits and request coverage
Get midwife care in a hospital, which is more likely to be covered by insurance
Work a side hustle to generate another stream of income
Look for a midwife with fees within your budget
Ask for a discount
As a last resort, use a credit card or loan
The bottom line
Midwife services are usually covered by insurance, but benefits vary. Your coverage depends on your insurance plan, the credentials of your provider, and where you give birth. MDsave estimated that the national average for a vaginal delivery with a midwife is $7,419, which doesn’t include prenatal and postnatal visits. Midwife care can range from $3,000 to $9,000 for prenatal, birth, postpartum, and newborn care services, but lab tests and birthing supplies are usually not included.
Why trust our experts?
References
American College of Nurse-Midwives. (n.d.). About midwives.
American College of Nurse-Midwives. (n.d.). Comparison of certified nurse-midwives, certified midwives, certified professional midwives clarifying the distinctions among professional midwifery credentials in the U.S.
Attanasio, L. B., et al. (2019). Midwife-led care and obstetrician-led care for low-risk pregnancies: A cost comparison. Birth Issues in Perinatal Care.
Creveling, E., et al. (2023). Medicaid financing of midwifery services: A 50-state analysis. National Academy for State Health Policy.
Krupa, A. (2023). This is how much it costs to have a home birth in America. Parents.
McCallum, K. (2020). What does a midwife do? Houston Methodist.
MDsave. (n.d.). Vaginal delivery with midwife.
Redwood Midwifery. (n.d.). Fees.
Tricare. (2022). Midwife services.
U.S. Department of Health and Human Services. (2010). Payment for certified nurse-midwife services.
U.S. Government Accountability Office. (2023). Midwives: Information on births, workforce, and midwifery education.
University of Utah Health. (n.d.). What does a midwife do?
Wilder Midwifery. (n.d.). Frequently asked questions.
