Who Pays The Midwife?

Most women in New Zealand have their babies under the guidance of a midwife and, all going well, this woman becomes a “professional friend” who gives you all manner of support as well as medical care.

This wonderful service is free to all Kiwi mums but the actual parameters are a little unclear, leading to rumours that midwives don’t want women to give birth in hospitals or have any kind of intervention, because they’ll be paid less.

This is far from the truth, says Sheryl Wright, a rural community midwife working in the north Waikato. In fact, community (previously called independent) midwives get paid set fees by the Ministry of Health regardless of what happens at the birth.

“There also seems to be a widespread and erroneous belief that midwives ‘get paid heaps’,” she says. She sets out to put the record straight.

Will my midwife be paid less if I give birth in hospital?
No. The standard fee for a labour and birth (regardless of how long it takes) is $1117 for women having their first baby and $876 for subsequent births. If it’s a home birth there’s an extra $451 to pay for a second midwife to attend and to restock medical supplies.

Does my midwife get paid less if I have an epidural?
No. A community midwife will be paid the full fee whether or not you have an epidural or if you require other interventions during labour or birth.

What about a Caesarean section?
This depends. If you end up needing an emergency C-section your midwife will still be paid the full fee. However, if you have an elective (planned) C-section there’s no birth fee but she can claim $318 if she attends the birth for support.

How many visits can I expect before my baby is born?
Most women will have 10 to 12 antenatal visits and midwives are paid $307.50 for the first and second trimesters and $297 for the third trimester.

How many visits can I expect after my baby is born?
Your midwife will visit you at home for four to six weeks after the birth. You can expect at least seven visits but the average is around nine. The fee paid to the midwife for postnatal care is $492. If you have a home birth or go home within 12 hours this fee goes up by $60 to allow for the extra visits your midwife will do in place of hospital services. If you need more than 12 visits your midwife can claim a further $159.

How much does my midwife earn?
If you’re having your first child and your midwife provides all of your midwifery care (including the labour, antenatal, postnatal visits, and assuming you don’t have an elective C-section), she will be paid a maximum of $2213 by the Ministry of Health.

Sadly, midwives’ fees have not kept up with the cost of living, says Sheryl. While the fees may seem like a lot, they are seriously eroded by GST, tax and expenses, such as rent, car costs, insurance and professional fees.

A case load of 45 women a year is recommended so, taking into account expenses and the variable nature of fees, midwives typically earn a pre-tax income of around $60,000.

Click here to read an extended version of this story in Sheryl's blog.