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  • Be your own boss - the pros and cons of private practice

    Author: Nicole Madigan

After many years of combining shift work and night duty with raising her own young children, midwife Caroline McMahon began to feel overwhelmed and exhausted.

“I was becoming ill,” says Ms McMahon.

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“I loved working within a busy hospital environment, the camaraderie with staff, constantly learning new skills and developing existing ones, lots of structure and regular pay.

“But the downside was that the dayshifts were not suitable to my family and nights were becoming increasingly harder for my body to cope with.

“Balancing the joy of both raising my children and continuing to work within a framework that wasn’t flexible made being able to work very difficult.”


Chief Executive Officer
Alexandra District Health
Sonographer Tutor
Frontline Health Brisbane

But instead of leaving the career she so loved, Ms McMahon decided to her hand at private practice, in order to work the hours that suited her and her family.

“Friends were turning to me to assist them as they had their babies,” she says.

“Soon, I found friends of friends and people outside of my friends’ circle were calling me to assist them, so I started a business to cater for the demand.”

To begin with, Ms McMahon set herself up as a sole trader, and set about meeting the needs of those women who were approaching her to assist.

“Initially I went casual at the hospital while I built up my practice, this gave me the flexibility to grow my business and the security of money coming in while I did this.”

In 2006, Ms McMahon set up a company with her business partner, and sought the advice of solicitors, bookkeepers, accountants and insurance brokers to ensure they were meeting relevant standards.

“We had never run a company before and found investing in expert advice to be invaluable.

“I ensured I kept up my midwifery education to meet registration standards.”

The evolution of technology meant Ms McMahon could develop a website, making her accessible to a wider range of clients, and since then, she’s never looked back.

“Being able to offer a service that our clients need, that is not available anywhere else, the joy of being able to support a new family is amazing.

“We can listen and have more freedom to deliver this service within safe guidelines for both the family and myself building a relationship of trust and support with our clients.

“I also have the flexibility in my working hours when I need them.”

As a private midwife, an average day for Ms McMahon starts with checking emails before heading off for morning home visits.

“The mornings is where I do most of my first visits. Often I’m home in the early afternoon eating lunch at my desk and answering emails and phone calls.

“I try to step away from the office between 4.30pm and 5pm.

“I offer two to three evenings per week as well as overnight midwifery support. My days vary in face-to-face and remote work, and also includes social media updates, media, administration and education updates.”

Like with anything though, there are some downsides.

“Being self-employed is the hardest I have ever worked.

“There is no one to fill in for me if I have a sick day, no sick leave and no holiday pay.

“Much of the fee I need to charge to stay in business does not go to me, people who have never worked for themselves before don’t understand where the money needs to go to stay fluid.

“I also need to service my current clients, who are often very stressed and sleep deprived, which is emotionally draining on myself, while ensuring I have work for the coming weeks ahead.”

For Kathy Fray, the decision to embark on a private practice was made at the very beginning of her career.

“I just was never really the hospital shift-working type of Midwife,” says Ms Fray.

“The rules, regulations, limitations, protocols, hierarchy, obstetric impatience leading to unnecessary interventions.”

Initially, Ms Fray went about building her self-employed caseload as quickly as possible, to be able to leave her part-time role at the hospital.

“But of course each new client has typically only just become pregnant, so it took 8-9 months for me to be able to become a full-time self-employed, case-loading midwife.”

Ms Fray says working as a self-employed midwife was the best decision of her career.

“Being your own boss - planning your own days most of the week.

“And always that hit of adrenaline when your phone rings. On-call midwives are typically Adrenaline Junkies.”

According to Ms McMahon, demand for independent midwives is increasing, as in-home services become a more accepted choice for addressing the multifaceted challenges faced by new families.

While private practice fits well into Ms McMahon’s life, she suggests thinking long and hard before leaving the hospital for good.

“It’s a lifestyle choice,” she says.

“Be prepared to work very hard, and if you love what you do, it will love you.”


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Nicole Madigan

Nicole Madigan is a widely published journalist with more than 15 years experience in the media and communications industries.

Specialising in health, business, property and finance, Nicole writes regularly for numerous high-profile newspapers, magazines and online publications.

Before moving into freelance writing almost a decade ago, Nicole was an on-air reporter with Channel Nine and a newspaper journalist with News Limited.

Nicole is also the Director of content and communications agency Stella Communications ( and a children's author.