Midwifery Students Tribe 2009 - Page 6

[BellaLuna Rayne]

All this discussion is some very interesting food for thought for me, considering I am just starting along this path.

[636Jen]

Originally Posted by BellaLuna Rayne

All this discussion is some very interesting food for thought for me, considering I am just starting along this path.

Here's a good place to start....

http://www.mothering.com/discussions...icense&page=54

[Om Girl]

Wow I certainly didn't mean to be a fire-starter with my comments about Ina May...I just wanted to express that it seems she's gone from one end of the spectrum to the other in the course of her history as a midwife. Just as I'm sure our opinions will change on various aspects of practice as we travel our own paths of midwifery.

[rebirth]

Om girl- it's a discussion board so that we can discuss things like this, so thank you! I know I learn a lot from hearing differing perspectives.

[MamaRabbit]

Yeah I was wondering when this thread would take off, so far it had been intro, etc, but now we get into the juicy stuff

Debates are good, it helps students to hear other view points and to come up with practice philosophies, etc.

[majikfaerie]

Originally Posted by triscuitsmom

I believe in midwifery care for all women. Every woman should have the one on one personalized care that midwifery can be.

ITTTA
I just wanted to add that I wouldn't be comfortable at all with a woman coming to me for prenatal care for a planned UC and not telling me that it was the plan. though considering my practice, I can't imagine this happening.
Midwifery isn't about the catch, IMO, so I really couldn't care if I'm not present in the birthing room at the 'crucial' moment.
For me, midwifery is all about being with women, supporting them, preparing them, and helping them to become empowered as strong, birthing women.
if someone wants to book in for prenatal care for a UC, i'm really happy to do it. I'm getting paid anyway, and assuming we all felt that the mama is on track, and she has absolutely no expectation of me attending her birth, then I would probably accept another client in the same month (still not in the same fortnight though).
I understand that in some places licensing and regulations might make this less viable, but still, in theory, i don't really see why it would be a problem. If a woman is informed, and plans to UC anyway, she still deserves to have the best midwifery care available for the pre and post natal periods, if she so chooses.

Originally Posted by MamaRabbit

Yeah I was wondering when this thread would take off, so far it had been intro, etc, but now we get into the juicy stuff

Debates are good, it helps students to hear other view points and to come up with practice philosophies, etc.

: :

oh, and MR, I met Chris... could be I'm coming your way for another visit in March :

[triscuitsmom]

Originally Posted by majikfaerie

ITTTA
I just wanted to add that I wouldn't be comfortable at all with a woman coming to me for prenatal care for a planned UC and not telling me that it was the plan. though considering my practice, I can't imagine this happening.

I just wanted to say that I plan to have the same sort of philosophy with my clients. I am totally open to taking on UCers for pre and postnatal care.

I mentioned my midwife doesn't know I'm planning to UC... and I wanted to clarify that if I could tell her and not risk having no prenatal care (which I personally am not comfortable with, especially with previous issues I have had during pregnancies) or risk her catching a lot of grief if I had to transfer and it was found out she knew I was planning it I would tell her. She already knows I'm comfortable birthing without her here, and that she may not make it because both my Mom and Gramma had very very fast (neither made it to the hospital delivery room) second deliveries after having long drawn out first ones (which I also had) and she is fine with that, we've talked back up plans and I know she isn't thrilled but she won't be shocked if she doesn't get here until after either.

[CanidFL]

I’m not clear yet on where I stand professionally regarding providing prenatal care to UC moms. I would have to check out my state laws more. But if that type of care is considered illegal here than I would absolutely not do it and would be pretty annoyed if a woman used me for prenatals and wasn’t clear about her plans.

As an individual, I support UC and feel that every women has the right to choose who attends their birth. I think UCers are very educated and do everything possible to make it a safe birth. I do have a nagging feeling in the back of my head wondering if there have been some bad outcomes that could have been prevented with a midwife present even if she was just sitting outside “on call” if something were to come up…..

I guess I don’t know enough about UC to make an educated answer.

On another note, I am now trying to get doula clients to help pay my way through midwifery school (tuition is due in August!). I’m very excited to start attending births but nervous about how to get the clients and feel confident. Are there any tips from the doulas here on how to get some clients? Does anyone have some time to look at my website and critique it? I know we are all busy so if you don’t have some spare time don’t sweat it. I will PM you the address if you are interested.

[MidwifeErika]

I think I would be ok with the UC thing... I won't know for sure until it happens though! I would prefer open communication though if they had no intention of calling me for the birth or if I was going to still be providing possible support if suddenly in labor they felt they wanted me there or what. I would want them to have a clear picture too of what things they could call me for and what things they would instead need to call an ambulance for. I wouldn't really like it if they planned the whole time of not calling me but didn't tell me that. However, they could tell me without losing their prenatal care. I really think I would just proceed with the mindset that they could always end up calling me in. Sometimes having a UC gets lonely if you run into questions and I would want them to have someone they could call with those questions.

[MidwifeErika]

Originally Posted by MamaRabbit

Yeah I was wondering when this thread would take off, so far it had been intro, etc, but now we get into the juicy stuff

Debates are good, it helps students to hear other view points and to come up with practice philosophies, etc.

Exactly. I was rather happy to see something to discuss pop up

It is good to share ideas and listen to the thoughts of others. It is amazing all the ideas I have picked up or changed by reading thoughts of others online. I think it is a good thing.

[Right of Passage]

So I have a question on this, when you give a client stats for the births you've "missed" I've heard it asked would you include your UC clients. My guess would be know. My state licensing, though it's fuzzy in my memory, you have to report the # of missed births/transfers/etc wouldn't that make your stats look bad?

FTR I struggle with the idea of licensing, or in my state registration. I don't like that I'd be bound to only helping specific women and that doesn't include multiples or breech. So spin off question, if you have licensing or registration how did you decide you would or wouldn't license/register with your state?

[MidwifeErika]

I would not include those who never intended on calling you in those numbers much like I wouldn't include anyone who transferred care to another provider to the birth. At least, that is how my brain sees it.

Well, there is licensing in my state. While I am against states requiring all midwives to be licensed, I will still get licensed. The reason I chose to do this is just that I really don't like breaking laws. The laws here in Wisconsin are pretty darn good, so I don't feel like there are huge groups not being served due to the license. If I were to move to a state where licensure is voluntary, I would have to think it over very carefully.

[BellaLuna Rayne]

Originally Posted by Nursingmama05

FTR I struggle with the idea of licensing, or in my state registration. I don't like that I'd be bound to only helping specific women and that doesn't include multiples or breech. So spin off question, if you have licensing or registration how did you decide you would or wouldn't license/register with your state?

WA has licensing requirements. I do plan to be licensed for a few reasons:

1) I do not like breaking laws.
2) Any illegal activity I participate in could reflect badly on my DH's career in the Army with him possibly being disciplined and I cannot risk that.
3) It opens me up to take on medicaid, low income families who might not be able to afford me if I was not licensed.

[cfiddlinmama]

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Great discussion. I'll be back later to join in!

[rebirth]

Originally Posted by Nursingmama05

So spin off question, if you have licensing or registration how did you decide you would or wouldn't license/register with your state?

Our liscensing is mandatory, with up to 5 yrs in jail for practicing midwifery without a liscense- so that was an easy decision.

I do like that there is a liscensing requirement for many reasons, but there are also some negatives- like restrictions about needing consults for things from an OB, and what term is..... and about which schools are acceptable! oh, and the fees are huge.

I like that transfers are simple, midwives can carry some meds, there is a minimum standard of care regulated and that a peer review process is a big part of staying liscensed. Plus we can take medicaid and insurance has to cover midiwfery if there is maternity coverage.

so overall I think it's good, but if it were up to me I'd change a few things.

[Right of Passage]

Originally Posted by hotwings640

I would not include those who never intended on calling you in those numbers much like I wouldn't include anyone who transferred care to another provider to the birth. At least, that is how my brain sees it.

That's what I thought as well but I needed some outside validation.

Originally Posted by BellaLuna Rayne

WA has licensing requirements. I do plan to be licensed for a few reasons:

1) I do not like breaking laws.
2) Any illegal activity I participate in could reflect badly on my DH's career in the Army with him possibly being disciplined and I cannot risk that.
3) It opens me up to take on medicaid, low income families who might not be able to afford me if I was not licensed.

That's what I don't like about the choice not to register, is that I would be illegal and I wouldn't want to put my family at any more risk than being a midwife already carries.

Originally Posted by rebirth

I do like that there is a liscensing requirement for many reasons, but there are also some negatives- like restrictions about needing consults for things from an OB, and what term is..... and about which schools are acceptable! oh, and the fees are huge.

I like that transfers are simple, midwives can carry some meds, there is a minimum standard of care regulated and that a peer review process is a big part of staying liscensed. Plus we can take medicaid and insurance has to cover midiwfery if there is maternity coverage.

so overall I think it's good, but if it were up to me I'd change a few things.

I like the peer review part and holding midwives to a standard but I don't like that I would have to terminate care at 42 weeks, or that breechs and twins would be an automatic transfer. I wouldn't be "allowed" to carry medication, only O2. Now we don't have to have a OB back up thats up to the client so I like that part but it seems so restrictive. I haven't even started school yet so who knows what might change with the laws or my view over the next several years

[ScarletBegonias]

Originally Posted by majikfaerie

I just wanted to add that I wouldn't be comfortable at all with a woman coming to me for prenatal care for a planned UC and not telling me that it was the plan. though considering my practice, I can't imagine this happening.
Midwifery isn't about the catch, IMO, so I really couldn't care if I'm not present in the birthing room at the 'crucial' moment.
For me, midwifery is all about being with women, supporting them, preparing them, and helping them to become empowered as strong, birthing women.
if someone wants to book in for prenatal care for a UC, i'm really happy to do it. I'm getting paid anyway, and assuming we all felt that the mama is on track, and she has absolutely no expectation of me attending her birth, then I would probably accept another client in the same month (still not in the same fortnight though).
I understand that in some places licensing and regulations might make this less viable, but still, in theory, i don't really see why it would be a problem. If a woman is informed, and plans to UC anyway, she still deserves to have the best midwifery care available for the pre and post natal periods, if she so chooses.

ita

i myself hope to be able to support as many uc'ers as a mw. i feel, as a pp said, that good, one-on-one midwifery care should be available to ALL women. if she's a uc'er looking for prenatal care, if she needs to know i'm there to mend a tear, or pp support, i want to be able to offer myself.

[Om Girl]

MN has voluntary licensure laws and I'm currently studying them now to determine where I stand.

On another note: What do you think about fees?
*If you miss the birth (on your own accord) do you charge a full fee?
*If you miss the birth (on your clients' accord) do you charge a full fee?
*If you have to transport do you charge a full fee?
When do you charge full fees and when do you accept less than full fee?

[MamaRabbit]

Not in practice yet, but

* will NOT charge full fee (refund part) if I miss the birth and it's my fault
* WILL charge fee if I miss the birth and it's client's fault
* WILL charge fee if I transport - still did most of the care, just because didn't do the "catch" doesn't mean shouldn't be paid; I plan on sticking with client in hospy as doula

those are my feelings at the moment anyway

[rebirth]

Originally Posted by Om Girl

On another note: What do you think about fees?
*If you miss the birth (on your own accord) do you charge a full fee?
*If you miss the birth (on your clients' accord) do you charge a full fee?
*If you have to transport do you charge a full fee?
When do you charge full fees and when do you accept less than full fee?

I will have my fees paid in fukll before the birth. If it is the clients fault I missed the birth (due to a fast birth or delaying calling too long, etc) I would keep the full fee. If I missed the birth I would certainly have had a backup there, so I can't imagine giving back part of the fee. If I transport I'm not sure...