Starting Your Own Midwifery Practice or Join One?

As a new graduate or experienced midwife, it is a big decision to start your own practice or join another established midwifery team instead. There are many pros and cons to each option. I would like to break down some things to think about when pondering these very different midwifery paths. Are you a new midwife or years of experience? Do you like working for someone else or doing your “own thing?” Have you ever ran a business before or always worked as an employee? Do you have any great midwifery practices in your area to join or need to start a practice to stay close to family? Is there a need for another midwifery practice in area?

I will start with all the great advantages to starting your own midwifery practice:

1. Control of your own schedule, services offered, and families you serve. You decide the office hours, fee schedule, mission, and values of your practice. You can take a vacation when you decide versus having to get approved by management. You can work 20hr or 100hr each week, versus paid salary and being told when you are working and what you will be doing.

2. The income potential is unlimited. You can charge whatever you would like for your care, choose how many births you will do each month, and decide how many hours you will invest into your practice. People will argue that I can only work so many hours so that does limit my income potential. Then I get people to think bigger than their own time restraints. You can hire as many midwives to be part of your team and transition into business owner versus sole proprietor mindset. Quit thinking of only leveraging your time, but all the wonderful midwives that want to work for a well established practice.

3. You can make change on a larger scale. Similar to the prior perk, you can make your practice as small or big as you want. You could create a birth center franchise across your entire state, like New Birth Company in Kansas with Cathy Gorden, CNM. You can provide midwifery care to many more families than if you were just a solo home birth practice.

4. Tax benefits of being a business owner. There SO MANY advantage in the tax realm with deductions compared to being a W-2 employee. You can write off mileage, business meetings, supplies, home office, continuing education. professional certifications, and much more! Retirement planning has so many better options with being a business owner than employee. I could go on and on about all the tax benefits for entrepreneurial spirited individuals.

5. Decrease chances of professional burnout. This can be possibility for owner or staff, but really depends on the foundational call coverage model practice creates. There is a constant adrenaline flow into a person’s body being on call all the time. If you don’t get collaborating midwives within your practice or another practice that covers each other for vacation, sick time, family events like recitals or sport events, the self care and work/life balance is extremely difficult to accomplish. With being an owner, you can choose staff model of call coverage. You can choose how many midwives will be on the team and how they will support each other. When you work for another midwife, you are more vulnerable to burnout since your boss will be making your employment contract, vacation requests, and terms of your call coverage.

Let’s get into the perceived negatives of being a business owner. Some people are not driven to be business owners and that is totally fine. You need to do a good analysis of your own personality and goals of responsibility within a practice. Do you want to know what days you are working and have off? Do you want to not be responsible for the budgets, marketing campaigns, and paying the bills for the business? Do you want a paycheck every two weeks versus waiting to get paid once all your staff and overhead expenses are paid? Being business owner may not be the best fit for you and that is totally fine.

1. Always available 24/7 for your staff, business needs, and complaints. It is really easy to say as employee when client isn’t happy, “Let me get my manager for you to help resolve this issue.” If you are employed, you can pass off many tougher parts of running a business.

2. You may work for many months without seeing your first reimbursement for your hard work and precious time. Business owners put in many hours, funds, and risk into starting a business and may never see return on their efforts if the business doesn’t have a good foundation to grow from with a strong business and strategic plan in place.

3. Starting a business takes time to learn that aspect of midwifery. Most schools don’t teach you how to run a practice, and primarily focus on the clinical training of being a midwife. That is a totally different schooling and takes time to learn. Getting certifications, finding business mentors, and reading books from other business owners will really help prevent mistakes with your practice that can increase chances of failure, burnout, and waste of valuable time.

4. There is a lot more responsibility than being an employee. You are responsible for yourself only when employed versus your entire staff needs you to run a successful midwifery practice. There is additional stress, demands, and expectations of the business owners than hired midwives. Are you the type of person that wants that level of expectations?

I am definitely biased towards midwives running their own practices, but think it is so important for each midwife to think about their goals in life and style of midwifery. Some midwives are better workers and others are better business owners. Know your drive, personality type, and the life goals you want to accomplish. If you want to change the face of midwifery options for women, it is very difficult doing that being a worker for someone else. Having a larger scale vision of opportunities will be much easier to accomplish with business ownership and beating your glass ceiling effect placed on yourself. We can create anything if we put our mind to it, just need to find your life’s purpose and fulfill it! That is all:)