Why Is It So Icky to Talk About Money? (Especially in Midwifery and Birth Work)
Originally shared in the Women’s Small Business Lab
Let’s talk about money conversations. Specifically within midwifery, but really this applies to most healing professions. If you’ve ever felt squeamish about asking for payment or setting boundaries around money, you’re not alone. Most of the women I coach are service-based business owners—midwives, doulas, therapists, yoga teachers—and this comes up all the time.
We care deeply. We want to help. But that often comes with guilt or discomfort around being paid. So let's unpack that.
The Backstory: Erika’s Dilemma
One of our members, Erika (name changed for privacy), shared that she recently took over clients from a retiring midwife (who was also her preceptor). Her own clients are paying just fine, but the ones who transferred over? Not paying on time, or sometimes at all.
Her preceptor had a pattern of not getting paid, not taking a paycheck some months, and eventually burning out. That pattern shaped the expectations of these families. Now Erika is stepping in and trying to clean it up. And she asked:
“How do I have clear, kind money conversations so I don’t burn out too?”
Let’s walk through that.
Step One: Know What You Actually Need
This is the most important piece. Before you can hold boundaries around money, you have to know what your financial needs are. Not just your rent and software subscriptions. I mean the full picture:
A fully funded emergency fund (3–6 months of business and personal expenses)
Retirement contributions
Health insurance or a health savings fund
A regular paycheck that supports your life (which is it’s own math problem to figure out)
These are not luxuries. They are requirements if your income is essential to your family.
If you skip this step, you’re more likely to wiggle on your rates. And when someone says, “I can’t pay in full,” you might say yes without realizing what you're saying no to on your own end.
The Math Behind Boundaries
Let’s say you calculate your monthly business and personal needs to be $10,000. And you want to attend no more than two births per month.
That means you need to charge $5,000 per client.
Now someone says, “I can only afford $3,000.” That $2,000 gap is coming out of your needs. So the question becomes: which of your own needs will you sacrifice to meet theirs?
Sometimes you might still say yes. But it won’t be a vague, leaky yes. It’ll be a conscious choice, and probably one you’ll make less often.
Money Conversations Feel Hard Because You Care
That’s the throughline for most people I work with. You care deeply. You love your work. It feels meaningful. You might even do it for free if your own bills were covered.
But the reality is that bills are part of the equation. And being in right relationship with your work means receiving fair payment for it.
Here’s a mantra you can try:
Receiving fair payment keeps me in right relationship with my work.
If you don’t get paid fairly, you're the one making up the difference—emotionally, physically, and financially. That’s not sustainable.
Tips for Having the Conversations
Start in the consult. Assume your clients want to pay you. Be clear, confident, and specific:
Explain your full fee
Outline the payment schedule
Make it known that payment is due in full by 36 weeks (birth worker specific :))
Require a minimum payment at every visit, unless they’re paid in full upfront
If you’re inheriting clients from someone who had more lenient practices, name it. Try something like:
“I know your previous midwife had a really flexible system. That doesn’t work for my life right now, so here’s how we’ll do things moving forward.”
Make it clear and kind. Payment is just another boundary, like when to call in labor or how to contact you after hours.
And yes, if payments aren't made, the next appointment should not be scheduled. That’s not harsh. It’s practical.
One Last Thought
Protecting your income protects your ability to keep doing this work. If you can’t pay your bills, this becomes an expensive hobby or side hustle, and eventually, something has to give. Often that something is you or your health.
Being vague about money isn't generous. It's confusing for both you and your clients. Clarity is a gift.
You deserve to be paid fully, fairly, and on time.
If the conversation still feels sticky, that might be a sign there’s a part of you holding on to an old story. I do parts work coaching around this exact issue—getting to know the part of you that feels weird asking for money and gently helping it heal. If you’re curious about that, let me know. It’s one of my favorite things to help with!
Thanks to Erika for sharing, and if you're reading this and nodding along, I’d love to hear what came up for you. Come share inside the Lab, or send me a message.