Business Overview

For most women, the birthing experience is a right of passage - the first opportunity to bond with this incredible new life being brought into the world. Each new mother has a vision of what this experience should be like and creates a birthing plan with that vision in mind. A midwife helps carry out that plan for families who envision a more natural, calming experience, free of a large hospital staff.

Who is this business right for?

Owning a midwifery business offers a unique opportunity to help families welcome their little bundle of joy into the world on their terms. Because newborns come when they’re ready, midwives must have the ability to keep a free schedule, prepared to jump in at a moment’s notice. This is a wonderfully rewarding career for the compassionate and loving individual who enjoys connecting and interacting with people on a more intimate level.

What happens during a typical day at a midwifery business?

In the midwifery business, no two days are alike. Even if you’re able to welcome multiple babies into the world each day, every family’s wishes and needs will be unique, as is each birthing experience.

While this will vary from day-to-day, most days will include the following activities:

  • Conduct interviews with families to get a feel for what their birthing needs are
  • Schedule and carry out regular prenatal checkups to ensure the pregnancy is progressing safely
  • Meet with mothers swiftly when they sense something isn’t right with their body or unborn baby
  • Assist families with whatever they require, once labor has begun
  • Deliver the baby and care for both mother and baby immediately after birth and assess the health and wellbeing of both
  • Provide care and advice if emergency interventions are required
  • Market your business
  • Consistently research to ensure your business is current with the best midwifery practices
  • Follow up with families after birth

Additionally, there will be administrative duties to attend to, such as ordering supplies and paying bills. Many midwife business owners delegate these responsibilities to their trusted staff, so they can focus on the needs of their “customers.”

What is the target market?

Your customers will be limited to a very specific group of individuals. Many expecting mothers are still choosing the path of birthing in a hospital, with a physician overseeing the process. Some of these women will be your clients, as many are now choosing to have both a midwife and a doctor in the room, with the purpose of ensuring a system of checks and balances. Others choose a more natural path, removing physicians from the equation entirely. This will provide the framework for your customer base, with many of them becoming an extension of your family.

How does a midwifery business make money?

While the cost of a midwife is significantly lower than a hospital birth, most insurance companies will not cover a midwife’s fee. Fees are agreed upon between the midwife and family, with many expecting families paying out of pocket. Due to the cost, many midwifery businesses accept payment plans, with the final payment due at 37 weeks.

What is the growth potential for a midwifery business?

More and more expecting families have realized the value behind having a midwife present during birth, helping to remove the “hippie” label that was once present. In fact, the industry is expected to grow by 31% by 2020, offering great opportunity for success for those considering opening a midwifery business. Growth opportunities are directly related to demand in your area and affordability of services, as well as the availability of other midwives in your region.

Getting Started

What are some skills and experiences that will help you build a successful midwifery business?

Because emotions can be high throughout the birthing experience, midwives must be strong and confident individuals. Attention to detail is critical, as a newborn’s life (as well as the mother’s) is in your hands. If something goes awry, you must be able to firmly, confidently, and calmly explain the situation to your birthing family and be able to execute an alternate plan swiftly, while still considering the outlined birthing plan. Additionally, it’s important to understand that these families are looking to you for guidance throughout this process. The ability to listen to your clients, often reading between the lines, is important, as is a passion for educating them every step of the way.

Those considering entering the profession can take two different paths to get there (depending upon your state). Certified nurse-midwives (CNMs) receive a degree in nursing, spending years completing their education. Some states also allow “direct-entry” midwives to practice, once they’ve completed an apprenticeship program with an experienced midwife. Regardless of which path you choose, the Midwives Alliance of North America offers a wealth of information regarding midwifery education, advocacy, and research.

What are the costs involved in opening a midwifery business?

When opening a midwifery business, entrepreneurs have an extensive list of needs. Part of why women choose midwives in their birthing plan is to have options regarding how and where they give birth. Since some women will want to birth in the comfort of their own home, many of your supplies will need to be portable. A percentage of your clients will, however, want to birth at your establishment, so it’s also important that you purchase or lease a space that can comfortably handle multiple births at once. Choose a location that is easily accessible, clean, and has a calming feel for your birthing mothers.

In addition to your space, you’ll need to budget for approximately $25,000 for the following supplies to get the business started:

  • General medical equipment and supplies
  • Blood sugar equipment
  • Resuscitation equipment
  • Birth kit
  • IV equipment
  • Needles and syringes
  • Blood collection equipment
  • Catheterization equipment
  • Cleaning solutions and equipment
  • Birthing tub kit
  • Marketing materials, including an educational website, business cards, and brochures
  • Insurance

What are the steps to start a midwifery business?

Once you're ready to start your midwifery business, follow these steps to ensure that your business is legally compliant and avoid wasting time and money as your business grows:

  1. Plan your business. A clear plan is essential for success as an entrepreneur. A few important topics to consider are your initial costs, your target market, and how long it will take you to break even.
  2. Form a legal entity. Establishing a legal business entity prevents you from being personally liable if your midwifery business is sued.
  3. Register for taxes. You will need to register for a variety of state and federal taxes before you can open for business.
  4. Open a business bank account. A dedicated checking account for your midwifery business keeps your finances organized and makes your business appear more professional to your customers.
  5. Set up business accounting. Recording your various expenses and sources of income is critical to understanding the financial performance of your business. Keeping accurate and detailed accounts also greatly simplifies your annual tax filing.
  6. Obtain necessary permits and licenses. Failure to acquire necessary permits and licenses can result in hefty fines, or even cause your business to be shut down.
  7. Get business insurance. Insurance is highly recommended for all business owners. If you hire employees, workers compensation insurance may be a legal requirement in your state.
  8. Define your brand. Your brand is what your company stands for, as well as how your business is perceived by the public. A strong brand will help your business stand out from competitors.
  9. Establish a web presence. A business website allows customers to learn more about your company and the products or services you offer. You can also use social media to attract new clients or customers.

Select your state below for an in-depth guide on completing each of these steps in your home state.

Where can I find a business mentor?

One of the greatest resources an entrepreneur can have is quality mentorship. As you start planning your business, connect with a free business resource near you to get the help you need.

Having a support network in place to turn to during tough times is a major factor of success for new business owners.

Recommended: offers video courses and a supportive online community of like-minded entrepreneurs. Try one month membership for for free.

What are some insider tips for jump starting a midwifery business?

The following are some insider tips from individuals who have found success in this ever-growing industry:

  • Get involved with organizations such as the Midwives Alliance of North America and National Association of Certified Professional Midwives. It’s important to have a support group of other midwives to ensure the best quality care for every client. They can also provide a wealth of information and resources to ensure the startup process goes smoothly.
  • Conduct interviews with expecting families before taking them on as a client. You’ll have an instrumental role in the event that will change their lives forever - understanding each other is key to a successful birth.
  • Consider accreditation through the American Association of Birth Centers.

Growing Your Business

How to promote & market a midwifery business

Historically, the women who chose natural births with midwives was a tight knit group within the community. Word of mouth was a midwife’s greatest marketing tool. However, as word spreads regarding the benefits of working with a midwife, centers are finding new marketing opportunities.

Midwife birthing centers have found success implementing the following marketing strategies:

  • Partner with pediatricians within the community who support a more natural approach to treating their patients. Their support and recommendation will take you farther in gaining valued clients.
  • Purchase ads in local publications, particularly those geared towards families.
  • Feature a blog on your website and share on social media. Focus on topics your expecting parents would inquire about, establishing yourself as an educator and leader in your industry.
  • Host workshops geared towards new families.
  • Google and Facebook ads are a great way to get your name out in the community.

Recommended: Get started with local advertising for your business with a $300 credit from Yelp.

How to keep customers coming back

Due to the services you’ll be providing, word of mouth is critical to attracting clients. How you treat them and how comfortable you make them from the moment you meet will define the relationship built. Women made to feel comfortable and in control will pass on their positive experience to others, encouraging them to consider you for their birth. Keep track of your clients once the baby arrives. They will, undoubtedly, consider you a part of their family and will look to you should they decide to have multiple children.

How and when to build a team

This will depend upon your personal preference. While not required, many midwives partner with a doula to assist with the birthing process. You’ll also want to consider hiring one or two additional midwives within the community to help your business grow. Since childbirth can come at any time and can last longer than 24 hours, it would also be beneficial to hire someone to take care of the clerical duties, so you’re not overwhelmed during those busy times. Just be sure the first person potential clients interact with is someone they can relate to. Most teenagers haven’t gone through this sensitive process and cannot begin to understand what expecting mothers are going through - find someone who will be sympathetic and can educate clients and prospects whenever necessary.

Whether you decide to hire employees or work solo, you’ll need the assistance of a reputable attorney. They can help ensure all your paperwork is in order and that you’ve purchased the necessary insurance to protect your business and your customers.

Legal Considerations

State & Local Business Licensing Requirements

Generally, midwives must be certified as either CPMs or CNMs and take a national midwifery exam. Information about certification can be found here.

The American Public Health System has published guidelines for licensing birthing centers. These guidelines can be found here.

Most businesses are required to collect sales tax on the goods or services they provide. To learn more about how sales tax will affect your business, check out our informative guide, Sales Tax for Small Businesses.

Most states require birthing center licenses. Learn more about licensing requirements in your state by visiting SBA’s reference to state licenses and permits.

For information about local licenses and permits:

Service Agreement

Midwife businesses should consider requiring clients to sign a service agreement before starting a new project. This agreement should clarify client expectations and minimize risk of legal disputes by setting out payment terms and conditions, as well as service level expectations. Here is an example service agreement.

Recommended: Rocket Lawyer makes it easy to create a professional service agreement for your midwife business when you sign up for their premium membership. For $39.95 per month, members receive access to hundreds of legal agreements and on call attorneys to get complimentary legal advice.

Reduce Personal Liability

Structuring your business as a limited liability company (LLC) ensures your personal assets are protected in the event your business is sued.

What is an LLC?

Form an LLC in 5 easy steps

Earning Potential

How much can you charge customers?

Midwifery fees vary depending upon location and specific services needed. Many centers report charging between $3,500 and $5,000 per birth.

What are the ongoing expenses for a midwifery business?

As a midwifery business owner, your largest expense is your physical location and supplies. Below are a few items you’ll want to budget for in your monthly expenses:

  • Insurance
  • Maintaining adequate supplies
  • Advertising and website maintenance
  • Continuing education

How much profit can a midwifery business make?

If you assist in the birth of 3 babies a month and charge $3,500 per birth, your agency will earn $126,000 before expenses. Hiring one or two additional midwives will not only help cover overhead costs, it can almost double your business’ profit, depending upon the pay scale you and the midwife agree upon.

How can you make your business more profitable?

The following are a few strategies other birthing centers have implemented to ensure a more profitable business:

  • Partner with local obstetricians and hospitals and offer assistance during hospital births when requested
  • Offer lactation consultations
  • Host regular events, such as prenatal yoga and infant CPR classes
  • Offer additional classes that would interest expecting parents - nutrition, prenatal, and breastfeeding
  • Many families choose to save the placenta, so this is a great service to include in your business’ portfolio

Next Steps

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