The Business of Midwifery

Midwives are independent contractors and must establish and maintain their own community practices. Midwives assume responsibility for all aspects of running an office including establishing and maintaining the physical clinic space as well as managing employees.

Midwives usually work in teams of 2 – 4. Some midwives work alone as “solo” providers.  A small number of midwives work in collaborative teams, sharing call with family doctors. Regardless of the practice structure, midwives ensure that they provide call coverage 24 hours a day 7 days a week.  This may mean very long periods of time providing care with little time off.  They also include a number of home visits and after hours calls that require owning and maintaining a reliable vehicle. Midwives must be immediately available by cell phone or pager to respond to client issues.  The midwife’s job can be challenging for young families and relationships and carries great professional responsibility.

Midwives typically care for 35-60 clients a year. All expenses related to operating a business such as rent, employees, materials and supplies must be paid from the income generated by billing the BC government for this care and can add up to 25-40% of their yearly billings. Midwives pay additional fees for registration with the CMBC, professional fees to the MABC and insurance premiums to the Midwives Protection Program (MPP). The full time fees for the MABC, MPP and CMBC are approximately $7500/ year which is about 6% of a full time midwife’s billings.  Full time midwives can earn around $80 – 90,000 after expenses from which they pay the Canada Revenue Agency their taxes.

We recommend you interview midwives to find out more about their professional life and how they manage work life balance. Upon graduation from a midwifery education program and completing regulatory requirements for registration in BC, midwives can begin providing their services; however, midwives may not be able to work in the community of their choice.  Midwifery job vacancies are advertised through the MABC and the national midwifery professional association: The Canadian Association of Midwives (CAM).