A Shoalhaven homebirth midwife will halve her case load under a new insurance scheme.
From 2027 only "endorsed" midwives with extra qualifications will be eligible for insurance to provide private homebirths.
The NSW health minister says he is concerned the insurance changes could have "perverse outcomes".
A regional NSW midwife says she will have to halve her caseload when federal changes to homebirth insurance take effect next year.
Under changes to the Commonwealth's Midwife Professional Indemnity Scheme, from 2027 only "endorsed" privately practising midwives will qualify for new, mandatory insurance to provide homebirths.
Registered health practitioners are legally required to hold Professional Indemnity Insurance, but privately practising midwives were exempt because no insurance product existed for them.
Endorsement is a higher clinical qualification, held by around 5 per cent of the workforce, that requires extra study and 5,000 clinical hours.
Jenny Spencer is the only full-time private homebirth midwife in Shoalhaven on the NSW south coast.
She said she would have to halve her caseload and increase prices under the new rules.
She said while she was endorsed and insured, a second midwife needed to attend private homebirth legally and none of the six women she used qualified.
"I haven't been able to find a second midwife who is endorsed," she said.
