Practical reporting on the clinical craft, licensing rules, and economics of running a solo or small community midwifery practice.
Every piece here answers one question a working midwife actually asks, in full, with the documentation and the numbers behind the answer. Written by Jimenez Julien of MidwifeLedger.
A transfer packet has to answer the receiving team's first questions before they ask them. Here is the field by field content that makes a handoff fast, plus what to say on the phone.
In network contracting, out of network billing with a superbill, and flat cash fees each reshape your collections timeline and your admin hours. A side by side look at how the money actually moves.
Most board complaints turn on the record, not the outcome. These are the documentation patterns that read badly under review and the concrete fix for each one.
Scope of practice for trial of labor after cesarean varies sharply by state, from outright prohibition to consultation and written plan requirements. Here is how to read your own rules.
Caseload math is a function of due date clustering, visit hours, postpartum days, and how much unbroken sleep you need. Here is how to build the number for your own practice.
Maneuvers, timing, personnel, and newborn response all have to be reconstructable from the chart. A step by step documentation checklist to complete before you leave the house.
Moving from home visits to a licensed facility adds building code, staffing rules, and accreditation to the workload. A close look at what shifts and what stays the same.
New licensure pathways, Medicaid coverage decisions, and payer credentialing shift what a community midwife can charge. What the direction of travel means for pricing.
Roles, medication sequence, quantified blood loss, and the transfer decision all compress into minutes. A ground level account of how the work divides between midwife and assistant.
The one page you hand a receiving labor and delivery team is the document every other habit in your practice feeds. Our field by field guide covers what belongs on it and how to have it ready before you leave the house.
What exactly belongs on a hospital transfer summary when I call ahead from a home birth?
Then work outward: the eight other pieces in The Birth Room Ledger each take one part of it further, and every one links back here.
