Negotiating Midwife Employment Contracts

Whether you choose to work for a company, hire midwives, or improve your current employment contract during evaluation, it is important to know what power you have in negotiating. Midwives are valuable and we need to act that way. Too many times I see scarcity mindset of “huge” competition for a position and midwives just take what is offered and appreciate job was offered to them. Certified Nurse Midwives are one the lowest paid Advanced Practice Nurses and I truly believe we do it to ourselves. We don’t demand what we are worth when hiring on and discussing salary benefits.

What a midwife hires on another team member to her business, there is so much lost opportunity to make creative employment contracts for long term retention and job satisfaction for staff. I am hopeful with time midwives get more business and negotiating training. School doesn’t teach you this part of professional career. It isn’t just about what salary are you offering me (that is just starting point of contract formation).

Big hospitals are more strict in what can and can’t be tweaked on their professional based employment contracts. Creative acquisitions are best with small, private practices. Midwives can discuss salary rate, sign on bonuses, relocation stipend, better retirement benefits, personal investment into company after certain amount of time working there (my favorite to show commitment and best long term investment profitability), productivity bonus, continuing education reimbursement, health insurance coverage, vacation time, sick leave, and health savings account contributions from employer.

My favorite is a health savings account (HSA). I have another discussion coming about the power of a health savings account for financial wealth creation. Please make sure your specific insurance plan can do a health savings account. Very powerful tool for tax free health coverage and account can be used for investing to grow faster if not used (fantastic tool to use with your health insurance plan).

Midwife contracts aren’t just about the money. Midwives need clear expectations whether hiring or being the one interviewing what the job description looks like. Are you doing full scope midwifery with births, prenatal care, gynecological services, primary care, infertility, or advanced procedures needing further training? Is the role against your personal beliefs (circumcision performing, abortion clinic assistance)? These are really important discussions to have during interview process.

What is the weekly schedule like? Does the job include working just five days a week in office 8-5pm with hour lunch? Will the call coverage be separate from office? What is the call ratio? Is there one midwife doing all coverage for patients during labor or large group of 15 midwives? Midwives need to understand their specific goals for practice.

I was always a medium sized practice midwife when doing birth coverage. If no birth call was part of contract, size of practice wasn’t as big of a factor. I liked have 3-5 midwives in a team to support each other, cover sick time and vacation, but lose the art of personalized midwifery. I didn’t even apply for large groups or tiny offices needing extensive obstetric coverage. Everyone is different. Same with posting positions, clearly state mission of practice and what your midwife business is looking for a in a midwife. We want to be respectful of everyone’s valuable when going through hiring process.

When hiring a midwife, have your personalized contract fit the needs of the valuable midwife in front of you. Learn during interview process what she is specifically looking for and see what can be adjusted on contract to make hiring process and retention more successful. If young family is important and discussed frequently with her interview, as the new potential boss, take notes and customize her employment contract to give additional perks for family time, insurance coverage, vacation time. It is all a budget game in back drops. Each midwife on team has a quantifiable business number budgetted for that staff member. You can break that budget up into salary, benefit terms, and additional perks that may actually costs midwife business more money.

If someone comes to you as a “workaholic” meaning older, single, minimal family/support team in area, and loves to work. Discussing productivity benefits, salary, and long term investment benefits like stock in midwife corporation would be powerful tools to use. If someone discusses moving far from family and barrier of picking this position, increase vacation time to see their distant family more often.

The key to negotiating in making a win-win for everyone. I have learned with time that when both parties are winners and the focus is how to make myself valuable for the other party, my wealth and personal requests are more likely to be accepted. Don’t forget the power of knowledge and value creation. Business courses help greatly with understanding each person’s position in employment contract negotiating more. Midwives want to be happy in their job and that includes having clear expectations on both ends what the contract will include and not include. Read them thoroughly. Have colleagues review with your contract. Lawyers are great to see if there is any jargon restricting your future practice (compete clause) if this employment contract doesn’t work. Know what to look for and what to ask for and the sky is the limit on your opportunities!