Homebirth is a beautiful and safe way for a child to enter the world (in most cases). Unfortunately, it is one that seems out of reach for many expectant mothers. The cost of a midwife can be high, and you also have to buy supplies. Many insurance companies still don’t cover homebirths, and those that do often have unreasonable requirements. (For example, Tricare only covers CNMs, but it’s illegal for CNMs to attend homebirths in my state!) There are ways to have a homebirth without breaking your budget, though, even if your insurance company isn’t going to help much!
First off, you have to chose a prenatal care provider. You have options! If you are comfortable with it, you can do self-care. This is the least expensive. You could also see a care provider that your insurance will cover, seeing the midwife only a few times during the pregnancy to develop a relationship. (Whether you divulge your plan to homebirth is up to you.) Then you’ll just pay for those few visits plus the fee for the birth.
You may be able to get your insurance to cover prenatal care with a midwife if you beg, plead, and keep calling up the chain. Many midwives offer some sort of discount or financial assistance to those who need it. Call around and try to find one who uses a sliding scale for payment. If you explain your situation, you should be able to find someone who will work with you. If you are comfortable with it, you could refuse certain testing or see the midwife less often than most do to limit your costs. (Just don’t do so at the cost of your well-being!) Many midwives also offer a discount for upfront payment for the prenatal care and birth altogether or payment with cash.
Second, you have to chose a birth attendant. You could be your own birth attendant. You can chose to have a midwife on call in case you need her–or not. The hospital is available in case of an emergency. Very few doctors or CNMs attend homebirths these days, but if you call and ask around, you may be able to find someone who’ll do it. Try small clinics and family practices. You have a much higher chance of having the birth covered by your insurance if a CNM or doctor attends.
Odds are, you’ll want a midwife to be there when you give birth–a CPM, probably. The charge to actually attend the birth is usually around $300, more affordable than many think. You could ask her if she’d charge less if you called her only right before delivering. She may offer a discount or sliding scale, like with prenatal care. Again, if you talk, she will listen. Most midwives will work with you!
You will also need some supplies, but really, it’s not much! If you want a water birth, here is an article describing how to have one without spending much at all: . The midwife will bring most of what you need, but she may have a few things she wants you to provide. Usually these are things like refreshments, toilet paper and maternity pads, and things for your comfort. Shopping at a discount, bargain, or dollar store will save you quite a bit. Usually the midwife instructs you to have towels and extra sheets; these are best purchased at a thrift store, in case you ruin them and need to throw them out.
I can’t estimate for you how much homebirth will cost, but odds are, you can find ways to make it cheap. It just takes some effort and work. How you will pay for it is another question. It usually costs over a thousand dollars, and most people don’t have that laying around. What do you do? Well, many midwives demand upfront payment even from those whose insurances will reimburse them. You’ll have to do the same thing they do: get a thousand dollars quick, or put it on credit.
There are ways you can raise money. First off, take a look at your expenses. What can you sacrifice? Consider things like the baby gear you were planning on buying. Could you buy it secondhand instead of brand new? Secondly, turn on the income faucet. Someone could get a second job a few nights a week for a little while during the pregnancy. There are ways of making money by working at home: Mary Kay and Avon which sell cosmetics, Slumber Parties which sells sex toys and love products, Associated Content, and GPT sites like Cash Duck and Deal Barbie Pays. You could babysit for someone or do odd jobs. Do you have a lot of clutter? Have a yard sale. What about your income tax refund?
If you do need to use credit, there are ways of limiting your costs. Apply for new cards that have an introductory rate of 0%. Be sure to pay it off or transfer the balance to a new card before the rate goes up. You may not be approved for enough to cover the whole she-bang. However, you probably can get approved for a few cards with low limits–like $500 each. Just spread the balance over a few cards, and keep your information organized. You can also set up a payment plan with the midwife. Could you charge the cost then pay it off with your income tax refund?
Not everyone can afford a midwife-attended homebirth. Some people are just at their limit already and cannot do it. However, there are ways of cutting the costs and getting the money. Take advantage of discounts; ask for a sliding scale. Beg your insurance company; endure lectures from doctors about how “unsafe” homebirth is while trying to find one who’ll do a homebirth. Earn some extra income; use credit cards, then pay them off. Live frugally for a while. You can make it work. You just have to put in the effort, and be creative!