This thread has been so interesting to read.
Again I want to thank all of those who spoke up with respect for what a hb mw is, and does, for families.
A couple points I want to address:
The legal, financial and social status of homebirth midwives has nothing whatever to do with me or any other mw. It is all about the legal, financial and social control willfully exerted by the Med System over all of health care. The greed and hegemony that has driven the AMA successfully to it's current status of control over health care and birth can only remain in effect as long as 'we, the people' stand for it. If someone has to drive a long way to get hb services, well maybe it is time for you to do some lobbying and promoting in your state so that more midwives are free to practice and there will end up being more of 'em in your area. Or if you're not going to do that then at least don't blame the mws, and don't complain about the situation that again, mws did not create and have been working so hard to change for 4 decades now (mostly with very little help from consumers who say they want a legal safe hb option but won't do much about it. But, to be clear, I add that SOME consumers have worked tirelessly and contributed unstintingly on behalf of safe, legal, universally available mw-care. But they are the minority).
As for those who wish to come late to care and get a discount, well I've seen it all. Mostly, these are very nice people who truly don't intend to rip me off, and many of whom I remain on friendly terms with--they just don't understand. Mostly, once they realize what I do offer by way of psych-emo-spiritual support, they are on the phone and email to me quite a lot even on top of what was supposed to be just a few visits (the few visits which are all they want to pay for because they are getting so-called 'prenatal care' from an OB via insurance). Now I don't mind really, because it does give us a chance to connect, gives me a chance to get to know the mom/family well and so, SERVE THEM BETTER as individuals (not as mere machines to whom I will apply science/tech skills impersonally). But giving so much of my time, energy and various holistic skills--well that is something I want to get paid for.
Not to mention that often, when a woman is seeing a med provider, there are at least a few if not many times when 'damage control' is needed--when she is being frightened needlessly by her provider and needs to be 'talked off the ledge'. This is something I'd rather not have to do--for my own sake as well as mom's/baby's--such stress is hard on pregnancy and birth (and is not much fun for me)! And this can most often be avoided if moms don't try to save money by getting what turns out to be highly inadequate 'prenatal care' in most cases *at best*, and highly stressful, potentially damaging care at worst.
Then there's the ones who *seem* cool enough--and who do not really avail themselves of phone/email, who really only want that 2-3 prenatals and then birth care plus maybe 1-2 early pp visits. Until you get to the birth and discover that maybe the dad is one of those super-controlling jerks who thinks HE can run the show....usually because 'God says he should' (!) which is a potentially deadly form of stress for mom and baby both. Hehehe--not to mention MY stress in a situation where I have to make nice when what I want to do is throttle him
And then, I realize just why they didn't want more visits: because dad does not allow his wife to get personal support from anyone; does not trust his wife or trust anyone else to talk to his wife, thinks God and him have it all in hand (and he wanted a mw why? hard to say....).
As for 'holistic'--well, being a Whole Person, and being understood and individually cared for by a mw as a Whole Person, is about far more than 'nutrition and exercise'. Body, mind, feelings, spirit....relationships, money, homelife, work, stress....
Not everyone I serve really needs much of the psych-emo-spiritual support I offer. Some moms/families are truly happy and healthy, have plenty of fam/social support and healthy ways of coping with stress, etc...interesting thing is, these are most always the people who are happy to pay my modest fee in full--even though they do need me less than some others--because they value my presence at their birth and postpartum, they value that I *am* available in so many ways in case they should need me in those various ways.
As a very Trust-Birth, Hands-Off mw, and a 3x UC mom, it is kind of amusing to be accused (hmmm, not 'personally' but more generally as a member of the class of mws) of making too much of what I bring to birth. My clients will tell you that early and often I tell them that they are very unlikely to need my 'serious skills' because birth works so well! As one pp put it--yeah, I'm kind of like an insurance policy. But when it is you, or your baby who DOES need my 'serious skills', you will find it quite the bargain and many times my price!
Thanks again lovely ladies, you're GREAT!