Midwives have clients, not patients. Midwives do not offer assembly line care, instead they specialize in individualized care. Midwives want their clients to be fully informed so they can make the best decisions for themselves as an individual. Midwives want clients to ask questions, to share things they have learned and to be collaborators in their care. Midwives give generously of their time. Instead of a 10-15 minute appointment, you may get an hour or more of the midwife's sole focus at each appointment. In the area of Kansas I serve, if you have your baby at the hospital, whoever is on call is the doctor that will attend the birth. If you have been seeing an obstretrician for care, this may be a doctor you have never met before. Midwives don't pop in just in time to catch the baby and then leave shortly after. With midwifery care, the midwife you hire is the midwife who will be at the birth (barring unusual situations). Midwives may spend several hours or even days supporting a client in labor, and will stay after birth for a few hours to be sure everyone is stable and doing well. Midwives do more than just a 6 week postpartum, most midwives will do 4 or more postpartum visits with the first two or more in the client's home. Some midwives have options to provide all their care in the client's home. When was the last time your doctor offered to come to your home?
If you don't have insurance and have to pay outright for a hospital birth in Kansas, you will be paying just shy of $11,000. My fee is less than 1/3 of that. For many people, my fee is less than the insurance deductible they would have to pay for OB care and a hospital birth. You are not locked into using only the providers covered by health insurance, you can choose to pay directly for the provider you want. Choosing a provider is a bit like buying a car. You can get the base, no frills model or you can pay more to get extra options. With a home birth midwife, the cost is actually less to have more options and care tailored to you and your unique needs and situation. Home birth midwifery is luxury care, especially when compared to the assembly line care so prevalent in American maternity care.