what are you getting your midwife, OB or doula as a token of gratitude??
I've talked with many birth professionals who stress that a thank you gift is lovely but not necessary, especially if one is paying "in full" for the services they provide. That said, gift certificates for restaurants or gas are practical and appreciated. I've also heard that hand made items are often preferred because of their personal nature.
At my first home birth I gave my midwife and doula necklaces with stones with supportive properties to help them sustain themselves in their challenging work.
I wrote my midwife and doula personal notes, thanking them for what I most appreciated about working with them. I enclosed them a box of her favorite chocolates (we had recently been discussing them LOL) for my midwife and some interesting new teas for my doula (we always chatted over cups of tea when we met). I agree that a gift is not necessary, but it felt right to me to give a token of my appreciation to these women who were with me through a big change in my life. The note was the "gift", really.