MidwifeLedger, or how to stop writing the same prenatal visit more than once · Updated September 8, 2026

One flowsheet, one column per visit

The setup is four steps and none of them are surprising. You enter the client and the dating (LMP or ultrasound), you chart visits in a ruled column format on a tablet or a laptop, the system checks values against the protocols your practice already wrote down, and you generate a summary when a chart has to leave the building. The stated appeal of the column layout is that a pregnancy becomes legible sideways: you read the trend instead of flipping through a stack of individual notes.

The audience is specific: licensed midwives (CPM, CNM, LM) attending somewhere between 10 and 120 births a year, solo practitioners or small birth center teams of two to four clinicians, in home birth and birth center settings, with written consult and transfer protocols already in place. That last condition matters, because the risk flags are thresholds you set, not medicine the software brings with it.

On which point, MidwifeLedger draws the line itself, in its own words: a flag never charts for you, it just makes sure the value is seen twice. That is the correct claim and it is worth repeating, because it is the difference between a reminder and a diagnosis. The software surfaces a number a second time. It does not interpret it, it does not decide anything, and it is not medical advice. The clinician reading the chart remains the entire clinical part of the arrangement.

The list of practices it is not for is published on the site rather than buried: full hospital inpatient records with order entry and pharmacy, gynecology and well woman care, anywhere a health system mandates its own platform, and anyone who mostly wants scheduling and marketing with charting bolted on the side. Refusing four customer segments in public is not a normal software marketing decision, and it is the most persuasive thing on the page.

The transfer summary is the actual product

The headline on the site is prenatal record, transfer ready, and the transfer summary is where the whole design points. It is one page, and the contents are fixed rather than left to whoever is assembling it at speed: dating, history, allergies, group B strep status, the last three visits, active flags, medications, and your current assessment. The pitch is not that this is clever. The pitch is that it is the same page every time, and that a receiving team can read it.

MidwifeLedger claims a transfer currently takes about 22 minutes to assemble by hand, and that roughly 1 in 9 charts misses a screening window. Those are the site's own figures, offered as the reason the product exists, and they are worth treating as a vendor's framing of a problem rather than as an independent audit. The tool's response to the second one is screening window tracking, which is to say a calendar that notices things, not a clinical safety net.

The offline behavior is the detail that suggests someone watched the actual job. Visits entered offline on a tablet reconcile when the device is back in range, and the transfer summary renders locally, so a weak connection never stands between a midwife and a printed page. Kitchen tables and birth centers are not known for their bandwidth, and a charting tool that stops working in a rural driveway is not a charting tool.

What it costs, published in dollars

Three plans, monthly, in US dollars, listed on the page rather than hidden behind a call. Solo Midwife is $49 per month and covers one clinician plus one apprentice. Practice is $109 per month for up to four clinicians plus apprentices. Birth Center is $229 per month with unlimited clinicians and students. Every plan includes unlimited clients, the full flowsheet, the risk flags and the transfer summaries, which means the tiers are about how many people are charting, not about which features got fenced off.

The business associate agreement is included at every tier. The site makes a point of it: a business associate agreement is included at $49 per month, not sold as an enterprise add on. Anyone who has ever been quoted an enterprise price for a signature will recognize why that sentence is on the pricing page.

Billing is monthly, you cancel from inside your account settings, and the plan ends at the close of the current month. There is no free trial advertised. The demo is described as a working chart rather than a slide deck, with no card requested at any point, and flag configuration is done with you on a call instead of shipped as a manual. Onboarding is quoted as one afternoon for a solo midwife and about a week for a practice of two or three clinicians.

Records, audit trails and getting your data back out

Records are encrypted at rest and in transit and held in United States data centers. Every open, edit and print is logged with a name and a timestamp, and that audit trail can be exported for a chart review or a board inquiry, which is the version of this feature that is actually useful rather than the version that only exists in a compliance PDF.

The export position is unusually plain: the records belong to you and your clients, not to us, so we do not gate the export behind a support ticket. You can pull full PDFs, CSV data and raw attachments whenever you want. A deleted account stays recoverable for 30 days. The site also states that it does not sell, mine or share client records and never uses them to train anything, which in 2026 counts as a feature.

Around the edges it does the administrative work a small practice cannot avoid: Quest and Labcorp results, lab attachments on the chart, postpartum and newborn charting so the record does not stop at the birth, superbills and board reports, and vital statistics fields formatted for state boards. It is written and maintained by one person who, by his own account, spent two years sitting in on prenatal visits and transfer calls before designing a single column of the flowsheet. That is either unusually patient product research or a very specific way to spend two years, and the flowsheet suggests the former.