MW leaving town on due date

[momasana]

A friend of mine is planning for a VBAC homebirth (HBAC?) She has been seeing her midwife since she got her BFP.

She found out four weeks before her due date that her midwife booked a birthday trip out of state, leaving town the morning of my friend's due date. My friend is understandably upset. She was told by the midwife that it isn't a big deal, that midwives do that all the time, and that is what back-ups are for.

Has anyone ever had this happen or heard of this happening? In my experience most MW will book vacation travel around due dates, or will not take on clients during a time they know they will be traveling. I know that sometimes early or late babies might come when the midwife is away, I'm just curious if any of you have experienced a midwife leaving on your due date.

[alegna]

I would expect to know ASAP if my midwife had a planned trip near my due date. Yes it happens, and especially where MWs work closely with backups it's not necessarily a HUGE deal, but it would be something I would expect to know from when the plans were made so I could make choices accordingly.

-Angela

[fruitfulmomma]

Uh, no that is not what backups are for. Backups are for emergencies when the midwife can't make it. Not so she can go play.

This should have been fully disclosed by the midwife when your friend started seeing her. She is choosing that particular midwife, not a group of them from whom she gets whoever is on call.

Totally unprofessional imo.

[annettemarie]

A similar thing happened to me with my last birth, although I was about a week overdue when she went. Luckily, I went almost 3 weeks over but I was really frustrated and anxious. ETA: I didn't know about this until about a week before my due date. It was some sort of surprise trip to see a concert or something her husband planned for her.

[laohaire]

Hmm. My thought is that this is normal. I mean, basically her options are to either never book a vacation, or forfeit an entire month's salary to do it. Both pretty lousy options.

Don't forget, the due date is a broad estimate which is the midpoint of a FOUR WEEK span. So to be almost certain to be around when your friend goes into labor, she has to block off an entire month of her life.

If I were your friend and I were bothered by this, I would consider the following steps:

- Get to know the backup midwife asap. She might really like her and have no problem with the idea of birthing with her. I would think it would be reasonable to ask for an appointment to meet her now. If she feels like she meshes with the backup, then there's no problem.

- If she doesn't like the backup, then weigh switching to another midwife or taking the chance that her midwife will be around (which is certainly possible).

I don't think it's unprofessional, especially since the midwife notified her. Around here at least, midwives don't make very much, and I can't fathom going without a month's salary to take a vacation for my own job, and I think I get paid a little more than midwives around here do (though I live in a state with only lay midwives for homebirth).

[frogautumn]

My midwife was away the week before my due date with DS#2. However, she had the trip planned well in advance and told me about it when we interviewed her at 10 weeks. I felt pretty certain that the baby would be late rather than early, so I felt comfortable signing on to work with her anyway. To my surprise, baby was 4 days early and arrived the day after MW returned home from her trip. Good timing!

However, I made a decision based on information I was given at the beginning. In your friend's situation, I would certainly feel dismayed!

[Defenestrator]

I think there is some kind of happy medium in between expecting that you would let clients know at hire of your plans and letting them know just weeks before you leave.

I know that, culturally, homebirth midwives are typically held to a high standard of being available 100% of the time and not taking any time for themselves, but I'm not sure this is totally healthy. On the other hand, I think it is a little bit dirty to pull this on someone just a few weeks before the birth. If this were my client I would be doing a lot of work to make sure that she got to know the backup and also making sure that she felt bonded to my apprentice so that the apprentice could do the bulk of the labor support and not make the mom rely on a stranger for that.

Sometimes it's impossible to schedule trips when no one is due. There are months when I've got women due every 6-10 days, and there are certainly midwives out there busier than me.

[TabithaB]

How long is she leaving for? 24 hours... 48 hours... a week... Considering the time span before and after due date 38-42 weeks. Maybe she is entitled to go on a little excursion on the fly if she has responsible back up. I don't think there is enough information to pass judgment. It depends on the circumstances.

[MsBlack]

Yeah, there should be some sort of happy medium....

For instance, it would have been better had the mw said from the beginning that she occasionally travels and could possibly end up being gone during your due date. She could have said--'and that's why I'll need you to meet my backup/s at some point during your pregnancy' (such as having one prenatal vis with the backup).

Yes, mws need a break, vacations, and a life beyond midwifery. But also need to be careful with clients about this matter!

[Banana731]

I think most people schedule their vacations or out of town trips pretty far out, midwife or not, no? If you know that you are going on a trip right near a potential clients EDD, I think it's right to tell her so she can make an informed decision when choosing you as her MW.

If it's something that you plan closer to the trip time then obviously you can't do that. I could see that being a difficult position for a MW. I think there is probably a tendency to think of HB MW's as being more dedicated to their work than your average CP. And while that must be true considering the hours and relatively low pay MW's get for the kind of care they give, everyone deserves to have a life outside of work-even if it is work they love. But even though I can totally rationally understand and concede that entitlement, I would still probably be a little sad if I were the OP's friend. After forming a connection like that with someone (provided I had felt that) I think I might feel a little less cared for than I had previously. It's just human nature. Like birth work doesn't have enough emotional gut wrenching attached to it already! Kudos to you, ladies!

[laohaire]

I reread the OP - this happened only 4 weeks before due date. Hmm.

It does depend on number of days gone, IMHO. If she's gone for a day or two I guess I'd just deal. A week is totally uncool with that notice.

Homebirth midwives are a bit different insofar as we do expect to develop a relationship with them. As opposed to an OB where you birth with whoever is on duty. So I think "that's what backups are for" is really kind of off. Yes, they are there to cover when you're not there, but that's different from just booking a vacation shortly before a birth, after the client has developed a relationship and trust and expectation that short of an unforeseen event (which is indeed what backups are for!), she will be there!

[turnquia]

I don't think this is unreasonable. My midwife left for 2 weeks and came back 2 days before my due date. (She told us 2 months in advance) It was a last minute special trip through her husband's work. All inclusive... she most definately deserved the break.

I went into labor 1 hour after she landed back here at home. Poor thing she was exausted but she made it to our birth. I even have pics of her napping

[dannic]

I don't know... it's a tough call. I am "due" Aug 28th and my mw will be gone Sept 1-5. I have some anxiety about it--and I knew from day one! If she were to lay this on me last minute, I would very uneasy and let down.

I have gone into labor within 3 days of my dd with all pregnancies, so I am hanging onto that and the fact that I still felt it was the right decision to go with her.

I know her backup (she attended my last HB with my MW) and I like her, but she is not my MW and I want my MW ,lol.

[fruitfulmomma]

For you ladies who think this is fine... Do you sign a contract with your midwife? Because I do and I am contracting with her for *her* services, not the services of her backup. Emergencies are understandable. Making plans for for her backup to take over so she can take vacations is not included in our contract.

[alegna]

I would want to know ASAP and I would want to "approve" who would be backing her up personally.

-Angela

[bluebirdiemama]

How long will she be gone. I would def want to be told right away, and meet several times with the backup. But it wouldn't be a huge deal to me, esp if it was just for a couple of days.

[Jlse]

For my first homebirth also a vbac due in January my midwife was given a vacation as a Christmas gift. The trip was something she would not have been able to do otherwise and asked how I felt about her going. I was fine with it and was happy she was able to do this with her family as she works very hard supporting lots of women like myself (no one else would take me). I did meet her back-up and yes she was gone when I went into labor. She drove back (4 hours) as soon as I went into labor and then left to be with her family an hour or so after baby arrived. The backup stayed with me and did the checkups in the days that followed. I told her I felt bad she had such a long drive and left her family - she told me she wouldn't have missed it and had already informed her family she might leave.

I have since used her through 2 more pregnancies and still thinks she rocks - I know how much she sacrifices for so many women.

In any case I would want to know how far she was going to be away and if she was willing to come if you were to go into labor. Having a vbac is more concerning and I would want to feel *very* comfortable with how is going to be taking care of me. I hope she is able to relax and have a great homebirth!

[Christine4kiddos]

This is a difficult situation.
As a midwife, with all the overlaps in EDD's... there really is *never* a time when you can be off call (depending on the busy-ness of the practice). Also, if I want to plan a long-range trip.. suppose i see a 2 week span in October where I am not on call... inevitably a phonecall comes in and that span of time is when this person is due! Closing a practice for a month can negatively impact business for a long time. And if you are the only choice for homebirth where you live, you can easily find yourself going YEARS without a break, because midwives believe in women having the birth attendant of their choice.
I think being up front with clients about taking time off is important... but if a one-day seminar is offered that I would really like to go to, I would make sure the mom would know as soon as I knew, make arrangements for the back-up midwife, etc. Inevitably, labors never start at noon... it's almost always at night! In that case, I would forego the seminar and attend the birth. The back-up is for the "just in case" labor starts in the middle of the day. I can't see a time where I would abruptly leave for more than a day, but then, no one has ever handed me a free trip before either!!

Clients also need to realize that if 2 women are in labor at the same time, they may end up with a back-up midwife for most/all of their labor. I recently covered for a midwife who had to transport a client to the hospital and another mama went into labor. This mama and I had a wonderful time and her birth was beautiful. She did not feel abandoned by her primary midwife.


Midwives are amazing women... we give MORE THOROUGH care, we give more intimate experiences, and we work MORE HOURS than any OB. And we are MAYBE paid a quarter of what traditional OB care charges, we are on the fringe of the medical community, and sometimes are scorned outright. We work illegally to help women birth, we work to LEGALIZE our profession so that insurance can cover our care. We accept less payment/barter because we recognize how difficult it is to pay cash for our care. We have no medical insurance of our own, unless we are fortunate enough to have a partner who has it through their job. We get NO PAID TIME OFF. We miss holidays, birthdays, anniversaries, camping trips, sports events and endless nights of sleep. And yes, did we know this when we became midwives. Sure!! But we also deserve to self-care.

Cut your midwife a break! If you have been happy with your care during your pregnancy, and you trust your midwife, please consider trusting her in this matter as well.

[MammaB21]

Originally Posted by fruitfulmomma

For you ladies who think this is fine... Do you sign a contract with your midwife? Because I do and I am contracting with her for *her* services, not the services of her backup. Emergencies are understandable. Making plans for for her backup to take over so she can take vacations is not included in our contract.

This. I'm paying a large amount of money out of pocket to have a homebirth midwife. One that I've gotten to know personally and that I've hand picked to be at my birth. My midwife made a big deal about that aspect of a homebirth. It's important to feel comfortable with the people that will be present for your birth. I certainly don't plan to pay any back up midwife whom I don't know well. If my midwife did that to me, honestly, I'd have to take a look at the contract and re-evaluate if I was going to continue services with her. I'd expect a refund if I decided to stop or switch services. (A partial refund obviously.)

As for the midwifes right to take vacation, I think there should be better planning involved. My midwife takes on quite a few clients each month (can't remember how many, but the number was higher than I expected). She said in the 20 some years she's been practicing she's only seen labors overlap infrequently and she's never actually missed a birth due to being at another. It seems to me she has plenty of steady income and could easily decline a client or two around the couple of weeks she'll be on vacation. Most of us don't get paid while on vacation, unless you have a great job with lots of PTO. Back up midwives are for emergencies, not vacations. This just seems unprofessional IMHO.

[bobandjess99]

I would expect the midwife to be up front with me from the get go, or as soon as she knew, and IMO, 4 weeks from the due date is NOT sufficuient notice. **ESpecially** a VBAC, where the relationship is geneally SOOO important to the woman...I mean, most women who are HBAC'ing have some SERIOUS issues going into the birth, so I think it is down right *bleep* for the midwife to tell her 4 weeks from the due date that she will be leaving. I would consider that a HUGE violation of trust, and would make sure to poorly publicise that midwife as much as i possibly could.
I am certainly not saying midwives shouldn't ever get a break, or take a vacation, but that they have a special responsibility to inform their clients, most of whom, as has been said, are contracting *especially* for that particular midwife's services, and with whom the "relationship" is so very much a part of the package deal, of the times when they will not be available.. I don't think midwives can emphasize that "personal" relationship as being so very important, and then at the last second say "nope, it's not, nevermind, I'm gonna go party, have this substitute". Exceptionally unprofessional.