Point-of-care ultrasound (POCUS) is becoming an increasingly interesting tool for midwives who want to expand the capabilities of their practices while maintaining a personalized, midwife-led model of care.
For a midwifery practice, however, the decision to add ultrasound should not be based solely on having access to new technology.
The better question is:
How can point-of-care ultrasound improve the quality of care while also strengthening the business?
When thoughtfully implemented, POCUS can potentially support both sides of a midwifery practice:
Better clinical information + better client experience + stronger practice operations + additional business value.
But those benefits depend on appropriate training, clearly defined clinical uses, appropriate documentation, compliance with applicable requirements, and a sustainable business model.
At Midwifery Business Consultation, we believe new technology should have a purpose. It should solve a problem, improve an experience, support quality, or create meaningful value—not simply become another expensive piece of equipment in the office.
What Is Point-of-Care Ultrasound?
Point-of-care ultrasound is ultrasound performed by a clinician at or near the location where care is being provided to help answer a specific clinical question.
In a midwifery practice, the appropriate uses will depend on the midwife’s training, scope of practice, applicable laws and regulations, practice policies, and the specific clinical situation.
POCUS may be used for appropriately limited assessments such as:
- Fetal presentation
- Fetal position
- Amniotic fluid assessment
- Other focused assessments within the clinician’s competency
- Clinical decision support
- Assessment that helps determine whether referral or additional diagnostic imaging is appropriate
POCUS should not automatically be considered a replacement for comprehensive diagnostic ultrasound.
That distinction is important clinically, operationally, and from a business perspective.
Benefit #1: More Information at the Point of Care
One of the most obvious advantages is having ultrasound information available when it is clinically relevant.
Instead of asking:
“What might be happening?”
the midwife may be able to obtain additional information to help answer a specific clinical question.
This can support more informed clinical decision-making.
The value isn’t simply the image.
The value is information that can be integrated into the clinical encounter.
Benefit #2: Supports Clinical Decision-Making
POCUS can potentially provide information that helps a midwife determine the next appropriate step.
For example, when assessing fetal presentation late in pregnancy, knowing whether the fetus appears cephalic or non-cephalic may influence counseling, follow-up, or referral.
The ultrasound does not make the decision.
The clinician uses the information as one component of the overall assessment.
This can make care more responsive and individualized.
Benefit #3: May Reduce Unnecessary Referrals
When appropriately used, POCUS may allow a midwife to answer certain focused clinical questions in the office.
That may reduce some situations in which a client needs to leave the practice simply to obtain basic information that could appropriately be assessed at the point of care.
This can create a more efficient care pathway.
However, this should never become:
“We have ultrasound, so you don’t need diagnostic imaging.”
POCUS should complement appropriate diagnostic services—not replace them when they are indicated.
Benefit #4: Can Improve Continuity of Care
One of the strengths of midwifery care is continuity.
When appropriate ultrasound assessment can occur within the midwifery practice, the client may be able to receive more of their care within the same environment.
Instead of:
Midwife → outside imaging center → results → another appointment → back to midwife
some limited clinical questions may be addressed within the existing relationship.
That can create a more seamless experience.
Benefit #5: Enhances Client Education
Ultrasound can turn abstract concepts into something clients can see.
For example, when discussing:
- Fetal position
- Presentation
- Placental location
- Amniotic fluid
- Other appropriate findings
a visual image may help clients understand the discussion.
This can make education more interactive.
And education is a major component of high-quality midwifery care.
Benefit #6: Can Strengthen Shared Decision-Making
Good decision-making depends on good information.
POCUS may provide additional information that can be incorporated into a conversation about options.
The midwife can explain:
“Here is what we are seeing.”
Then discuss:
“Here is what that means.”
And ultimately:
“Here are the options available to you.”
The technology should support informed decision-making—not replace it.
Benefit #7: Can Improve the Client Experience
Clients increasingly value convenience.
Imagine being able to have an appropriate focused ultrasound assessment during a visit rather than arranging another appointment elsewhere.
That may mean:
- Fewer appointments
- Less travel
- Less waiting
- Less scheduling
- Faster clinical information
- Greater continuity
Convenience is a legitimate component of healthcare value.
Benefit #8: Can Increase the Perceived Value of Your Practice
From a business perspective, adding appropriate technology can influence how clients perceive the sophistication and capabilities of a practice.
A practice offering:
Personalized midwifery care + appropriate technology + convenience
may have a compelling value proposition.
But the technology should reinforce your brand.
It should not become your brand.
Your practice should still be known for excellent midwifery care, not simply for owning an ultrasound machine.
Benefit #9: Creates an Additional Service Opportunity
Depending on your practice model and applicable requirements, POCUS may create an opportunity for an additional service offering.
This could potentially be structured as:
- Part of routine care
- A separate service
- An appropriate cash-pay service
- A package component
- An insurance-billed service when permitted
The appropriate model depends on the practice.
Before creating a fee, verify applicable coding, payer, scope, and regulatory requirements.
Benefit #10: Can Create Ancillary Revenue
An appropriately designed ultrasound service may generate additional revenue.
But revenue should never be the only reason to add it.
A sustainable business model should consider:
- Equipment costs
- Training
- Maintenance
- Staffing
- Documentation
- Billing
- Insurance
- Supplies
- Utilization
- Compliance
- Replacement costs
The important question isn’t:
“Can we charge for ultrasound?”
It is:
“Can we provide this service at a price and utilization level that makes the investment financially sustainable?”
Benefit #11: Can Strengthen Practice Differentiation
Midwifery practices compete for clients in increasingly diverse healthcare markets.
Some practices offer:
- Home birth
- Birth center care
- Hospital-based midwifery
- Prenatal-only services
- Well-woman care
- Lactation
- Education
- Expanded ancillary services
POCUS can potentially become one component of a differentiated practice model.
For example:
“Personalized midwife-led care with convenient point-of-care assessment when clinically appropriate.”
That can be a stronger marketing message than simply:
“We have an ultrasound machine.”
Benefit #12: Can Support a Premium Care Model
For some practices, the goal isn’t necessarily to compete on price.
It may be to create a higher-value care experience.
That might include:
- Longer visits
- Continuity
- Education
- Personalized care
- Convenient services
- Appropriate technology
- Expanded access
POCUS can become one component of that premium experience.
But remember:
Premium pricing requires premium value.
The service must actually deliver something clients value.
Benefit #13: May Improve Practice Efficiency
Time is one of the most valuable resources in a healthcare business.
If an appropriate focused ultrasound assessment can be completed during a scheduled appointment, it may reduce:
- Additional scheduling
- Outside referrals
- Administrative coordination
- Client travel
- Delays in obtaining certain information
The result may be a more efficient workflow.
However, this benefit only exists if the service is integrated thoughtfully.
Poorly designed ultrasound workflows can actually make a practice less efficient.
Benefit #14: Can Increase Client Retention
Clients tend to value healthcare experiences that are:
- Convenient
- Personalized
- Responsive
- Educational
- Consistent
When POCUS supports those characteristics, it may contribute to client satisfaction and retention.
And retention has significant business value.
Keeping an existing client is often less expensive than constantly acquiring new clients.
Benefit #15: Can Support Your Practice’s Referral Relationships
A strong midwifery practice knows when to refer.
POCUS does not eliminate the need for referral relationships.
In fact, having clearly defined referral pathways can make your practice stronger.
A well-designed model might look like:
Midwife identifies clinical question
↓
Appropriate POCUS assessment
↓
Finding reviewed
↓
If reassuring and within scope → continue appropriate care
If concerning or uncertain → referral/diagnostic imaging
This demonstrates that technology is being used as part of a larger clinical system.
Benefit #16: Can Help Build a Stronger Clinical Team
Introducing POCUS can also become a professional development opportunity.
A practice may develop:
- Training pathways
- Competency standards
- Image review
- Quality assurance
- Continuing education
- Peer learning
This can contribute to a culture of professional growth.
The key is to make competency systematic rather than assuming that attendance at a training course automatically equals ongoing competence.
Benefit #17: Encourages Clinical Standardization
When POCUS is implemented thoughtfully, it can encourage a practice to define:
- Indications
- Protocols
- Documentation
- Referral criteria
- Quality assurance
- Training expectations
This can strengthen overall practice operations.
Interestingly, the process of adding ultrasound may improve other systems within the business.
Benefit #18: Can Increase Perceived Professional Sophistication
Technology can influence how clients view a practice.
A well-designed POCUS program can communicate:
We are a modern practice that combines evidence-informed midwifery with appropriate technology.
That can be particularly valuable for practices seeking to demonstrate that midwifery care and technology are not opposites.
They can coexist.
But Technology Alone Doesn’t Improve Quality
This is an important distinction.
Buying an ultrasound machine does not automatically improve clinical quality.
Training improves competency.
Protocols improve consistency.
Documentation improves communication.
Quality assurance improves reliability.
Appropriate referral improves safety.
Clinical judgment makes the information useful.
The machine is simply a tool.
The Business Case Requires Utilization
An ultrasound machine that is used twice a month may not make financial sense.
Before purchasing equipment, estimate:
How many clients could appropriately benefit?
How many scans are realistically expected?
Will the service be included or separately charged?
What is the average revenue per use?
What are the variable costs?
How long does each examination take?
What is the opportunity cost of clinician time?
How long until the equipment pays for itself?
These are business questions every practice should answer.
Calculate Your Break-Even Point
For example, suppose your total initial investment is:
$15,000
and your estimated contribution margin is:
$100 per scan.
Your simplified break-even point would be:
150 scans.
But that number is only useful if your $100 contribution estimate is realistic.
If actual contribution is $50 per scan, you would need:
300 scans.
This is why financial planning should happen before equipment purchasing.
Consider the Hidden Costs
The machine isn’t the only expense.
Consider:
- Training
- Continuing education
- Maintenance
- Software
- Image storage
- Supplies
- Cleaning
- Documentation
- Billing
- Staff time
- Insurance
- Quality assurance
- Equipment replacement
These expenses should be included in your financial model.
Consider Equipment Replacement
Eventually, your ultrasound machine will need to be replaced.
A successful business should not wait until the equipment fails to think about replacement.
Build equipment replacement into your long-term financial planning.
Your service should generate enough value to support not only today’s operation but tomorrow’s equipment needs.
POCUS Can Strengthen Your Brand—If You Position It Correctly
Your marketing shouldn’t focus exclusively on the technology.
Instead of:
“We have ultrasound!”
consider positioning it within your overall care philosophy:
“We combine personalized midwifery care with appropriate point-of-care technology to provide convenient, individualized care throughout pregnancy.”
The difference is significant.
The first sells a machine.
The second sells a care experience.
Avoid Overpromising
Your marketing should never imply that POCUS:
- Guarantees a healthy pregnancy
- Replaces comprehensive diagnostic imaging
- Detects every complication
- Eliminates the need for referral
- Provides certainty in every situation
Responsible marketing builds trust.
The Best POCUS Programs Combine Four Things
A successful program sits at the intersection of:
1. Clinical Quality
The service is appropriate, competent, and integrated into care.
2. Client Experience
The service provides meaningful convenience, education, and value.
3. Business Sustainability
The service makes financial sense.
4. Risk Management
Training, documentation, policies, scope, billing, and referral pathways are appropriately addressed.
If one of these is missing, the program becomes weaker.
Ask These Questions Before Adding POCUS
Before purchasing an ultrasound machine, ask:
Clinical
- What clinical questions will we use it to answer?
- Is this within our scope?
- What training is required?
- What are our referral criteria?
Operational
- Who will perform the scans?
- How will they be documented?
- Where will images be stored?
- How will the workflow fit into appointments?
Financial
- What will the equipment cost?
- What are ongoing costs?
- How many scans are needed to break even?
- What will we charge?
- What reimbursement can we realistically expect?
Business
- Will this attract new clients?
- Will it improve retention?
- Will it differentiate us?
- Will it improve efficiency?
Risk
- What policies are needed?
- What insurance considerations exist?
- What happens when findings are abnormal?
- How will competency be maintained?
The Real Value of POCUS
The value of point-of-care ultrasound isn’t simply:
“We can do ultrasound.”
The real value is:
“We can appropriately integrate focused ultrasound into a high-quality midwifery care model in a way that benefits clients, clinicians, and the business.”
That’s a much more powerful concept.
Final Thoughts
Adding point-of-care ultrasound to a midwifery practice can potentially create meaningful benefits on both the quality side and the business side.
Clinically, it may support:
- More timely information
- Clinical decision-making
- Client education
- Continuity
- Appropriate referral
- A more integrated care experience
From a business perspective, it may support:
- Additional service opportunities
- Ancillary revenue
- Client convenience
- Practice differentiation
- Client retention
- Premium value
- Operational efficiency
- Practice growth
But the key is intentional implementation.
POCUS should not be added simply because the technology is available.
It should be added because it supports the practice’s mission and because the practice can provide the service competently, appropriately, compliantly, and sustainably.
The strongest midwifery practices don’t ask only:
“What can we add?”
They ask:
“What can we add that meaningfully improves care and strengthens the business?”
That is the difference between adding a service and building a strategic practice.
At Midwifery Business Consultation, we help midwives think through both sides of that equation—because the best business decisions are the ones that support excellent care, excellent client experiences, and a financially sustainable practice.
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