Originally Posted by olstep
I have never got a decent answer when I tried to find out what that "catch up" talk is about.
My understanding is that majority of woman who opt for HB are well-informed, well-read and take good care of themselves. They would at least have all lab. work done and most likely see an OB regularly.
I am sorry, but I have a feeling that the "catch up" talk is just a talk to justify her fee. Personally, I'd stay away from this type of MW.
Wow. This really bugs me.
unfortunately, though most women who opt for hb care do try to inform themselves and take good care of themselves, without the guidance of a mw who really knows homebirth, a family's self-informing and self-care may actually fall somewhat short of 'good enough'. Their 'self-informing' may be all about 'hb safety' (to convince themselves and families) and 'labor prep', but not so much about nutrition and other elements of holistic self/baby care. They may have watched some videos and heard good hb stories, but really have not considered the nuts and bolts of preparing for, and having a homebirth, breastfeeding, postpartum recovery....Mom may be very well informed but Dad utterly clueless. Not to mention that OB prenatal care falls quite abysmally short of adequate to help women stay healthy, and believe it or not many families think that all they have to do is listen to their doc, have their labs done. So, if their OB did or didn't say it, then it's assumed to be either 'true enough' or 'we didn't need to know that'....meaning that there really *can be* quite a lot of 'catch up' to do. Catch up on information, undoing misconceptions....
And I'm with Paige--getting to know people well enough, establishing mutual trust--these things are so very important to the success and smooth, happy running of a homebirth. This takes time; so when people come late to care for any reason I may give them a small discount (IF they have had some prenatal care already) but not much-- because I'm going to see them as often as possible in the time we have left before the birth. And seeing them as often as possible means that I will have to make rapid adjustments in my own scheduling expectations and consciousness both (to mentally/emotionally 'make room' for these new people)--these things are a form of work as well, and believe me it is harder work than having at least 20wks or more to integrate clients in all necessary ways.
As I have often tried to explain to potential clients--this is not like your typical OB managed experience. Homebirth with a mw will NOT be 'just like a hospital birth, only at home'. I am not merely the kind of med/surg technician that an OB is--an OB doesn't ever have to have met a woman prior to managing her birth because OBs apply a fairly standard set of impersonal, universal rules, protocols and so forth. Their type of 'medicine' can very often rescue women and babies from the inadequacies of OB prenatal care and ill-nourished, minimally informed and generally unprepared women. Does a mom's labor stall? Fine, give 'er some pit and/or do surgery. Is mom malnourised and therefore prone to excessive bleeding--ok, we can fix that too, with meds or surgeries. And so forth.
But what a hb mw does is far different. It is holistic, and highly individualized, finely nuanced and time-intensive.
Finally--sure I understand that for some families, $$ is an issue and they hope to let insurance pay for some of the care and then get a discount from a mw. But we mws DO have to make a living, and it generally IS a fairly modest living at that. Besides, I do this work primarily because I love doing this work--and I happen to believe that my own happiness and joy are pretty important to doing this job well along with helping to keep me healthy for my own AND clients' sakes. It is my prerogative, therefore, to make choices about how I'll do this work. I prefer to meet people sooner, and to be paid full fee--this is more comfortable for me and it seems to work quite well for my clients also (at least judging from my stats and happy customers). So what? Making such choices does not make me greedy or otherwise somehow suspect.
To be clear, I have met some families at the last minute that were a joy to serve--we 'clicked' immediately, they were very highly self-responsible, and all went perfectly well without a hitch--allowing them a discount was no problem at all. But then there have been those latecomers where it did not all go so well--in terms of birth itself, and in terms of the 'joy factor'. And to be perfectly frank, they were generally the ones who DID think they could hire me, and treat me, as if a mere technician who could 'just catch the baby'. They really didn't get it, did not see or respect the core of my way of working; they really weren't so prepared or self-responsible; they did not care to establish trust and comaraderie with me; there generally were more issues and even scary moments during/after birth for them. Things that of course they figured *I* should be able to rescue them from....at a discounted rate, of course. And accept the blame--and their gossiping about me all over town-- if I couldn't rescue them, of course.
Thanks to all who have said you understand why coming late to care should not automatically mean a big discount of a mw's fees