I feel like I'm drowning...

Hi everyone! I'm coming to this thread seeking some advice/thoughts/empathy/anything helpful. I am an independently licensed counselor in a very rural area. It has always been my dream to help grow mental health care and resources in the area since we are certainly lacking. I currently work for a for-profit outpatient clinic which I really don't care for. I love the flexibility and autonomy though. My last job was in CMH which was a nightmare... we had more resources but my own mental health was struggling and we were constantly asked to do unethical things.

I've been in my current job for over a year now. I make $47/billable hour for the first 20 hours. After that, the rate slightly increases. I thought this was good when I initially did the math, but I did not account for documentation, research, communication, etc. that I would not be getting paid for. I know this is standard if I were to go private practice, but I do not feel the pay rate is fair at times. They also make you see at least 24 clients weekly to keep benefits, so accounting for no-shows and cancellations they "encourage" you to schedule 30+ per week. We get a lot of no-shows and cancellations because mental health is kind of taboo in our area and there are a lot of barriers.

I am drowning. I am a full-time PhD student writing dissertation and I have slacked on it due to feeling so drained. I am also 8 months pregnant and about to be on a very shitty maternity leave where I have to return to work likely before I am mentally or physically ready to do so. I want to start my own practice badly, but admittedly I am scared of failure. It's a small town. Also, private pay is not really an option and the majority of my area is Medicaid. I also hate being all telehealth and would love to have a physical office, but the costs intimidate me.

I love my job as a therapist. When I keep my eye on the prize, I do well mentally. But, I also need to make a decent living and I'm barely able to pay our bills even with my husband's income which is good. I feel like I'm not contributing and like I deserve more for the time and effort I have put in my education. I work part-time as an adjunct for two universitys, so this is a nice cushion if needed, but I cannot always rely on their need for me to teach.

I am just so scared. I want to be a present mother to my son that is coming soon. I want to provide financial stability for our family. I want to keep loving what I do and have the flexibility. But it all feels so far from my reach.