having a midwife just to "catch" the baby? - Page 6

[fairydoula]

Originally Posted by olstep

We are talking about grown-up women not babies who have no language skills and can't speak their needs, aren't we? Would you say it your client's expectations were not clear for you after the interview?



I do not understand why you need to give up on your personal life, family events, etc for 6 weeks to provide your service on the one only day when actual birth will happen.
I am not a MW and I do not know this job.

If we believe that prenatal appointments are so important and most work is done before the birth, than what should be the fee for the birth itself?

It is not the fee I am questioning. But hypocrisy: they push the service I am not asking for, claim that I need it while it is them who need/ want it and ask me to pay for it.
When it comes to money they are business women, when it comes to the service they are paid for, they feel offended with the fact that they are hired. They are free spirited artists who provide holistic care.

Why not be honest? If you can't or are not willing to provide the service I am looking for, just put it straight. Why to act like a sale person and impose the whole package which you are interested in (due to the lack of practical experience or a financial reason) but not me?

It is not directed to you, mbhf. I have no problem with anything you said in you post.

You're quite obviously NOT a midwife or you would probably not be this offensive. I don't know whether or not you mean to be, so I will assume the best and consider it ignorance, rather than willful argumentativeness.
What is your particular problem with midwives charging a global fee? I am still not getting that, even though I've read through the posts twice.
I am a midwife in training, although on hiatus right now. WHY am I not practicing and apprenticing now? Because I simply can't afford to work for free. Most midwives in my area charge between $900 and $1500 for their TOTAL fee. They just can't afford to also pay an apprentice... usually not even much to help cover gas costs.
They work VERY hard and they get paid VERY little for the skill, love and care they put into their work. Most midwives DO develop relationships with the mothers they serve. The relationships can be varied... from close friendship to a temporary connection that serves well during the pregnancy, labor/birth and after care, but naturally fades into the background as the mother moves on with her life and the midwife goes back to work.
I have gotten up at 3am to drive over an hour to help an amish couple birth their first baby. Upon arrival, I found I was at the wrong house. Since amish houses have no electricity, there are no lights, so I went to another mom who lived on the same road, due at the same time, but it wasn't her. Then, I got stuck in the mud of their yard. Couldn't be pulled out, so the poor dad had to hitch up the buggy so I could be taken to the right house where the mom was in labor. I ended up staying with them for over 18 hours, as my truck was stuck and the mom's labor was long and slow and she needed a lot of comfort and reassurance. When I finally got home that evening and got in bed, around 1030 or so... I woke up with a start at 3am again... the OTHER mom was now in labor. So, fresh clothes on and back to work, another hour drive, another long-ish birth and a beautiful happy baby and family. But exhausting, definitely!!!

I had been on call for these women and others for weeks. It's NORMAL for us to be on call for several weeks. On-call for me means I don't drink more than one glass of wine in a 24 hour period. I don't leave my hometown. I don't plan an overnight trip. I don't book other engagements. I let other clients know i may have to cancel and or rebook things if that mom goes into labor. As a massage therapist, this has cost me MONEY to have to cancel appointments for massage to attend a birth. This affects my family. I don't throw parties that i can't reasonably expect to have to leave in the middle of. I know that I may miss a party for one of my kids, or I may have to rely on family or friends to drive my kids somewhere, or chaperone them or just simply BE there for them if I cannot.
These are just some of the sacrifices I make to ensure I can be there when a client needs me. There are more, which I'm sure other midwives would be happy to list if you needed more examples.
Calling midwives businesswomen and free spirited artists who provide holistic care is a compliment to me. It sounded as if you wrote it as an insult. I don't get that. The more sucessful midwives I know are GOOD businesswomen. They make sure that their clients are very clear about payment expectations. They are clear and firm about their fees, upfront, so that the families can make budgetary adjustments and can decide to decline to hire them if the fee is beyond their range. They ALL work on a sliding scale. I have yet to meet a midwife who has not done a birth for "free" as the fee she eventually collected didn't even cover, or barely covered her expenses.
I'm not sure what your underlying angst is or seeming anger towards "hypocritical" midwives, but you have a lot of misconceptions, IMO.
Most midwives work for very modest salaries, spend a HUGE amount of time working with or for their clients and deserve a lot of credit and respect for the jobs they do.
Forgive me if my post seems harsh. I do not like to see my chosen profession disparaged so, especially when I know the truth.
- Jen

[Jaimee]

I haven't had a chance to read this entire discussion, so please forgive me if I repeat something, but I wanted to pass on my experience.

I was receiving prenatal care from a mw that I had to terminate services with around 36 weeks for a variety of reasons on both our sides. At any rate, I had to find new care or go for a UC. We decided to go for the UC, but my family freaked out on me saying things like I was going to die and the baby was going to die. I did a lot of research during this time about complications and talked to three different midwives about what they were and were not comfortable doing during a birth. Essentially, what some of the pp's have mentioned is a very real problem: a midwife cannot simply show up for just the birth, especially not to just catch the baby without risking a lot. She needs to have background knowledge and she needs to have knowledge of the birth progression to do her job to the best of her ability. This isn't to say that mw's don't sometimes do this or that sometimes the birth proceeds quite quickly and they show up just in time or even after the fact. But purposely putting the mw in that position is not a moral thing and can end up costing us another midwife and we need all the midwives we can get!

Now, with that explained, I'm not saying that you are asking for that situation. It sounds more like maybe you're wondering if you can switch to mw care so late in your pregnancy? And the answer to that is yes. I did in fact switch to a different mw at 37 weeks and she was perfectly fine with that. I also asked her to be very hands off, allowing me and my dh to do everything. I wanted her in the other room as back up just in case, but if everything was fine, I wanted to do it ourselves. And this was totally fine with her. IME, this is not the case of MOST mw's, however. This particular mw was very experienced and very well known within our birthing community and by OB's in the area. She is highly respected and can "get away" with stuff that other mw's could not. The other mw's I spoke with wanted to do much more during the birth than sit in the other room (even the other CPM's I spoke with) in order to maintain their licenses.

My second mw charged me 2 of the 3 parts of the global fee: the birth and postpartum fee, which is about 3/4 of the entire package, and a few other charges for things like rhogam. The prenatal care is hardly anything. So for me, I ended up paying about $2400 out of pocket up front, but once I filed with my insurance (as an out of network provider) I only paid $1000 or so in total. This process took about 6 months and required appeals, but it was well worth it. I have UHC POS, which I chose purposely for my homebirth.

All in all, you have to find a way to birth that is right for you. Birth doesn't happen every day. It has the ability to be utterly transformative if allowed to be. If it requires that you pay a little more out of pocket I think that is worth every penny.