Free tool
Midwife caseload and call coverage calculator
See how many clinical hours a month your caseload really takes and how many days sit between due dates before you agree to another client.
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Global maternity fee hourly calculator
Enter the flat fee you charge for a full course of care and see what it really pays per clinical hour once every visit, the birth and the paperwork are counted.
A global maternity fee looks like a large number on an intake form and a much smaller one by the time the six week visit is done. Between those two moments sit a dozen prenatals in other people's houses, a night that ran fourteen hours, postpartum visits that cannot be moved, an assistant to pay, disposables, labs, and the paperwork nobody counts. This calculator counts all of it.
The defaults describe a fairly ordinary solo picture: a flat fee of $4,800, twelve prenatals at roughly ninety-five minutes door to door including the drive and the note, twenty-two hours across the birth and postpartum care, about $700 per client in assistant pay, disposables, labs and newborn screening, and six hours of administrative work. Replace each figure with your own and watch the hourly number move.
Your result
Total hours per client
47.0
Every hour one client takes from intake through the six week visit.
Net fee after direct costs
$4,100
What is left of the fee once the assistant, supplies and labs are paid.
Effective rate per hour
$87.23
Your gross hourly rate before overhead, malpractice coverage and taxes.
Share of hours spent on paperwork
The portion of a client's hours that no one is present for.
This is a gross figure per client, before rent, malpractice premiums, continuing education, phone, vehicle and self employment tax.
Why door to door is the only honest visit number
Midwives routinely quote prenatal visits as forty-five minutes or an hour, which is true of the time spent sitting with the client and false about the time the visit consumes. A home visit twenty minutes away is at least eighty-five minutes of your life, and the note adds ten to fifteen more unless you write it at the table before you stand up.
Run the calculator once with chair time and once with door to door time and compare the hourly figures. The gap is the strongest argument there is for either raising the fee, tightening the geographic radius you serve, or moving early prenatals to a single office day where the driving happens once.
What to do when the hourly figure disappoints you
There are only four levers and none of them is working harder. Raise the fee. Reduce direct costs, which usually means renegotiating assistant pay per birth or buying supplies in a different quantity. Cut hours, most realistically the administrative six and the driving. Or take more clients, which the caseload calculator will tell you whether you can survive.
Of those, administrative hours are the one most midwives underestimate and the easiest to shrink. Charting a visit twice, rebuilding a transfer summary by hand, and re-keying dates for a biller are all pure loss. When you cut two hours per client from that column, at twenty-four clients a year you have bought back a full working week.
Questions about this calculator
Should I include on call hours in the birth and postpartum figure?
Not the passive waiting, or the number becomes meaningless. Count attendance from the time you leave for the birth, plus the newborn exam, cleanup and the drive home. If being on call genuinely prevents paid work, price that separately in your fee rather than by inflating hours here.
What effective hourly rate should a solo midwife be aiming for?
There is no single right number, but remember this figure is gross and personal overhead has not come out. Malpractice coverage where you carry it, continuing education, licensure renewal, vehicle costs and self employment tax all sit downstream of it. Midwives who compare the result with what they would earn per hour precepting or teaching usually find the comparison clarifying.
How do I use this if I bill insurance rather than charging a flat fee?
Enter what you actually collect for a full course of care, not what you bill. Take an average of the last several clients who completed care and use that figure. If collections take four months, the hourly rate is still correct but the cash flow story is worse, which is a separate conversation about your reserve.
More free tools and working documents
Working document
The hospital transfer packet checklist
Everything a receiving labor and delivery team needs from you, in the order they will ask for it, so nobody is copying dates onto a legal pad at three in the morning.
The fastest lever is the admin column
Whatever figure this page just gave you, the hours spent re-keying visit dates, retyping a handoff page and charting the same prenatal twice move it more than a fee increase will. In MidwifeLedger the note you write at the kitchen table is the note a receiving hospital reads, and the risk flags fire without you opening three prior visits to find a blood pressure trend. Book a walkthrough, then run this calculator again with a smaller admin number.