Setting up your Midwifery Practice
Setting up your midwifery practice from the beginning can be overwhelming and daunting. Take things day by day. Make a list of things to do: supply ordering, marketing, business plan, funds, birth assistants, malpractice insurance, legal paperwork like CLIA, business entity registry, consultation arrangements, and license to practice in the state.
Find a mentor in your area to help you. Make it a win-win situation by offering to work in her office as a volunteer while the midwife shows you her business model and provides years of knowledge about running an independent midwifery practice. Midwives getting close to retiring want to pass on their skills and wisdom. Your practice will grow much faster with the next retiring midwife as your main referral source for her clients. Talk about a cheap way to market your practice by taking over another midwife’s caseload when she decides to end practicing midwifery.
Figure out what your midwife’s practice vision looks like
Do you want to do home births birth centers, birth center franchises, well-women clinics, niche services like pelvic floor therapy, or breastfeeding support only? The possibilities are endless. Midwives are pushed to work long hours and in hard situations at times. If you don’t love what you do, it will be hard to stay with the practice during tough times. Starting out, there will be many late nights and days without seeing your family. Make sure your mission and cause are worth leaving your family to create this amazing midwifery practice.
Writing a business plan will answer many of the start-up and planning questions. Having a mission, goals, services rendered, budget, competition list, inventory, resources, staff training, birth assistants, billing, marketing, and practice location will really help smooth out the planning and running process once the doors are open. Most start-up businesses close in five years (90%+). Spending time preparing and planning stages of expansion and actual monetary needs for each wave of slowness and rapid growth will decrease your stress level. By focusing on planning before doing your busy midwifery role, the day-to-day operations will become dramatically simpler.
Professional burnout is a real thing and grows every day.
Health care is a demanding profession and midwives sometimes give their entire lives to serve women. We can still be great midwives while having a family/personal life. Creating a balance from the beginning and boundaries of what your practice will have from you will cut the divorce rates, adult children that won’t talk to midwives anymore, and missing phenomenal vacations away from the practice.
Many of my blogs repeat the same theme: self-care. We want successful, long-term, stable midwifery practices. I want women to have more midwives to choose from than OBs for prenatal care. I am grateful for high-risk care providers if a woman is sick. Midwives are the experts in normal birth and need to do business training to compete with the current healthcare challenges in midwifery.
Spend just as much time training to be a midwife as business classes. If you want to work for someone, just focus on midwifery. Most midwives dream of running their own utopian practice. We can ALL do that successfully with proper business knowledge.
We have a sample business plan in the store to save many hours of planning and preparation. Customize it to your needs and be professional, looking to banks for a loan and potential consultation doctors. It is amazing how many more doctors worked with me once I sat down and showed them my business plan.
It shows people that don’t know you, “She is serious. This practice will be successful and decrease my risk by interacting with her. She knows what she is doing.” Trust is quickly captured with medical communities when safety is shown with policies of risk-out criteria, transport plans, and evidence-based practice protocols. The unknown causes fear for customers and the medical community. Brag about your planning, training, and policies in the midwifery practice.
Many of my long-term established relationships are from repeated meetings ahead of time rather than waiting until there was an issue with a patient or a poor outcome. Be proactive versus reactive with women and their babies. Safety is shown by planning, preparing, and coordinating resources ahead of time. Have family practice physicians, obstetricians, and pediatricians in your communities planning to serve.
It is harder to get them to sign a written agreement (especially when employed by a larger organization versus a private practice). Informal relationships are just as important as written ones. Have regular meetings (bring them lunch to their offices every few months) to show appreciation for your collaborative relationship. Kindness and positive gestures really help during 2 a.m. phone calls from patients, and a doctor is needed to be called for consultation recommendations.
Inventory is a Tough One
My personal preference is to buy in bulk and pay for storing items. That is great for an established practice. When you are starting out, buy just the items you need to safely care for families and the volume you anticipate having. Allows for spares of essential items like a doppler, stethoscope, blood pressure cuff, thermometer, neonatal resuscitation equipment like oxygen tanks, bleeding medications, delivery instruments, charting forms printed, and protective barrier supplies like gloves. Get organized with your office and birth bags. Spending precious time looking for an item when you arrive at a woman’s house when she is close to delivering is not acceptable.
Funding is a big perceived barrier for many midwives (especially hospital midwives wanting to branch out on their own). Money is always available if your business plan is strong,, and money will be made. You can find start-up investors, SBA loans from banks, or family support loans for your cause with proper passion and planning. Figuring out what you really need for money is hard. Each midwife will need a different amount.
It depends on the size of the practice vision, the area served, birth center versus home birth practice, solo practice versus larger midwifery practice, or business regulation overhead costs. Don’t let the money scare you away. Take business classes, crunch the numbers from the research you did, and see if the volume you want to serve will cover overhead and your goal salary.
Things to do when starting a midwifery practice
The biggest thing I want everyone to take away from this blog is to plan, prep, and have sufficient funds available as backup for business start-up eb and flow. We all can have our dream midwifery practice. Be determined, passionate, and knowledgeable about the business side of midwifery, rest will fall into place! Relationships will be made with like-minded midwives and knowledge will be passed back and forth. Use your resources and get inspired today to create the next best midwifery practice in your town.
We created the course, Tips for Running a Successful Midwifery Practice, to teach you all you need to know about being a midwife.