How much does a midwife cost? Hospital, birth center and home birth

A midwife costs about the same as an OB if you give birth in a hospital, and usually less if you give birth at a birth center or at home. The catch is that out-of-hospital care is far more likely to come out of your own pocket. For people with employer insurance, pregnancy, birth and postpartum care for a vaginal hospital birth averaged $15,712 in total, with $2,563 of that paid out of pocket ^[1]. A 2021 survey of home birth midwives found an average package price of $4,650 ^[2].

Your real cost comes down to three things: where you give birth, which type of midwife you hire, and whether your insurance or Medicaid pays that type of midwife. This guide covers all three. For what each credential means, see our guide to the types of midwives.

How much does a midwife cost by birth setting?

Midwives usually charge a global fee: one package price that covers prenatal visits, the birth and postpartum care ^[2]. In a hospital or birth center, a facility charge comes on top of the midwife's fee or is bundled into one price.

A few things to know about these numbers:

• The hospital figures are what the insurer and the patient paid together. They include the hospital stay, the clinician who attended the birth, and prenatal and postpartum care. They come from the Peterson-KFF Health System Tracker's analysis of employer plans, and they count only hospital births ^[1].
• The birth center average is older and isn't adjusted for inflation, so expect current quotes to differ. It combines professional, facility and newborn fees ^[2].
• Credentials change the price a little. In the home birth survey, CPMs charged an average global fee of $4,619 and CNMs charged $5,202 ^[2].
• Some midwives sell a delivery-only package. About a quarter of home birth practices (24%) offered one, at an average of $3,777 ^[2].

Is a midwife cheaper than an OB in a hospital?

Not by much. In a hospital, a CNM bills for the same maternity services an obstetrician does, and the hospital sends its own bill for the room, nursing care and supplies. Public payers increasingly pay midwives and doctors the same rate:

• Since 2011, Medicare has allowed CNMs up to 100% of the physician fee schedule amount for the same service ^[4].
• In 2025, 29 states and Washington, DC, paid CNMs 100% of the physician's Medicaid rate for a vaginal delivery, up from 25 states and DC in 2023 ^[5].

With private insurance, what you pay depends on your deductible, coinsurance and out-of-pocket maximum, the same as with an OB. Choosing a CNM practice for a hospital birth mostly changes who's in the room, not what the hospital charges.

Does insurance cover a midwife?

Usually, as long as the midwife is in your plan's network. Plans sold on the ACA Marketplace must cover pregnancy, maternity and newborn care, both before and after birth ^[6]. That rule makes plans cover maternity care, but it doesn't put every midwife or birth setting in network.

How coverage tends to work by midwife type:

• CNMs are licensed in every state ^[2] and bill insurance like other clinicians. Hospital-based CNM care is the most likely to be in network.
• CPMs and other licensed midwives may not be in network. Insurance doesn't cover home births in many cases, which the authors of the 2021 survey say helps explain why only 20.9% of home birth practices listed a separate fee for insured clients ^[2]. Those that did charged insured clients an average of $5,050 ^[2].
• Birth centers need both the facility and the midwife to be in network. Our birth center cost guide breaks down those bills.

Before you sign a contract, call your plan and ask about the specific midwife, by name, and the specific hospital or birth center. Our guide to whether insurance covers midwives goes into more detail.

Does Medicaid cover midwives?

Medicaid has to cover certified nurse-midwives in every state. Coverage for other midwives, and for home births, depends on where you live.

State licensing is the first hurdle for CPMs. In 2023, NASHP counted at least 37 states and DC where CPMs were legally recognized to practice ^[10]. A CPM can be licensed in your state and still not be paid by its Medicaid program. Where Medicaid does pay CPMs and CMs, 10 states and DC pay them the physician rate for a vaginal delivery, and the rest generally pay 70% to 90% of it ^[8].

The result shows up in who pays for home births. In 2017, Medicaid paid for only 8.6% of planned home births, compared with 43.4% of hospital births ^[3]. If you're on Medicaid or might qualify, see Medicaid for pregnancy, then ask any midwife you're considering whether they're enrolled with your state's program.

How can you pay less for a midwife?

• Ask about a sliding scale. Many midwives in the 2021 survey said they're willing to lower their fees for clients with low incomes ^[2].
• Get a good faith estimate if you're paying yourself. If you're uninsured or not using insurance and you schedule care at least 3 business days ahead, providers must give you a good faith estimate. If the bill comes in at least $400 over it, you can dispute it within 120 days ^[11]. An estimate lists charges from one provider or facility, so ask the midwife and any birth center separately ^[11].
• Check your network early. Ask at your first prenatal visit, not at 36 weeks, so you still have time to switch if the midwife isn't covered.
• Price out the extras. A global fee covers prenatal care, the birth and postpartum care ^[2], but lab work, ultrasounds and supplies may be billed separately. Get the list in writing.

What to ask a midwife about cost

• What's your global fee, and what exactly does it include?
• Which labs, ultrasounds and supplies are extra, and who bills me for them?
• Are you in network with my plan? Is the hospital or birth center?
• Do you bill my insurance directly, or do I pay and file the claim myself?
• When are payments due, and what's refundable if I transfer care or move?
• If I'm transferred to a hospital in labor, what do I still owe you?
• Do you take Medicaid, and do you offer a sliding scale?
• Can I have a written estimate before I sign?

When you're ready to compare practices, start with our midwife directory.