Q for MW's re: when do I say "enough is enough"

[secondimpression]

I had a homebirth 5 *months* ago and am still not settled up with my midwife. Her office keeping skills are horrific and it seems like every time we talk, she's asking me for more money while promising me paperwork that I never see. I'm starting to wonder when I need to say "enough already!"

I just got an email from her today that she wants $150 for a Rhogam injection. This is news to me since the last time we talked, she agreed that I only owed her a final payment of $800, which I sent a check for. Am I crazy to have assumed it was included in her global fee? There was nothing in our contract detailing an additional fee for the Rhogam. She definitely never told me at any time how much it was going to cost or that it was going to cost anything. If this is indeed "industry standard", I have no problem with it beyond her really bad office skills.

This isn't the first time she's surprised me with new charges. At 38 weeks pregnant, her assistant asked me for money out of nowhere. I looked into it and saw that this was normal but come on! Tell me from the beginning that I'm going to have to pay $700 to your assistant and exactly how much the birth supplies cost that you want me to buy.

I haven't had a postpartum exam because when I asked to schedule it, she said my account wasn't settled up (waiting for her to straighten out mistakes she made with my insurance). At this point, I don't want her anywhere near me in a medical capacity for fear of what other "standard" charges are going to pop up out of the blue that she forgot to mention. And I hate to say it, but for as perfect as she was for my birth, I wouldn't hire her again because of her billing practices. I don't think she's trying to swindle me, I think she really is simply disorganized but at what point do I say "this is ridiculous, no more money"?

[newsolarmomma2]

I'm not a MW, but Im a businesswoman and I think you should stop giving her ANY more money. You should have had a contract, and thats what you should pay, no more. If there are added fees, you should have been notified BEFORE you got the service. If you need more services from her, get everything in writing before you go ahead with it. You should also ask for a print out that itemizes all you have paid fornalready, especially if you didn't have an agreement up front.

I understand being kind with a Mw who did a good job, but is just a bit disorganized. However, it has to stop somewhere. So long as you have paid her what she originally requested, you owe no more. Don't make a big deal out of it, just tell her "You did a great job, but I cannot pay any more new fees. I believe I am being fair, and have paid what you quoted. I appreciate all you have done, but I budgeted according to the fees you told me about, and don't have money for add ons that I wasn't aware of."

Professionals deserve to be paid, and you did this already. Don't stress it!

[riomidwife]

Rhogam is very expensive and $150 is just about what we have to pay for it as midwives....But care should never be compromised because of financial issues. Did you have a specific contract? I suppose if you signed a financial agreement that says you would pay X amount by a certain date it is within the midwife's ability to discontinue care, but I don't know any midwives who would fail to follow up with someone postpartum because the client wasn't paid up. That's just horrible. Is she a CPM? If she is registered with NARM you can file a complaint with them, if that feels warranted to you. If she is a CNM you can follow up with ACNM.....If she is neither than there is no accountability,and that's why consumers and birth workers in MD are trying again for regulation. I'm from DC/MD.

[secondimpression]

Thanks ladies, so glad to hear that I'm not being completely irrational here! DP likened it to paying someone to remodel a house and then billing you for the flooring 5 months after the fact because "oops, forgot about that!" It's frustrating.