Edited by Madeline2015 - 3/2/13 at 9:56am
Well if nothing else they definitely should have cleaned up more, that is terrible you were left with a mess and your husband had to deal with it right after the birth.
How long did it take her to get there after you called and said she should come?
If it was me, I probably wouldn't ask for a lower fee, though it does seem sort of unfair that they didn't really do their part. But I am pretty sure most contracts say that they are not at fault if they don't arrive in time, particularly for a precipitous birth. It also might say on there somewhere that you can expect it to take 1-2 hours for them to arrive after they call. If you have a copy of the contract still you should take a look at it again.
I don't know a ton about it of course, but from what you said I don't think that she really could have assessed the situation much better than she did. Birth experiences vary greatly, but "normally" you don't go from contractions 10 minutes apart to pushing nearly as fast as it sounds like you did. I think usually one of the most reliable ways to tell what phase of labor a woman is in is how she feels. Not that it is your fault by any means for not knowing the baby would come so fast, but it didn't sound like you were having many of the typical signs of active labor or impending pushing.
When you go to talk to her, I'd probably mention at the very least that you were disappointed with their lack of helpfulness after the birth and not cleaning up like they had promised and maybe just ask why she wasn't able to arrive on time. You don't have to be confrontational about it, but try to communicate why you are bothered, then hopefully she can respond thoughtfully without feeling defensive, and maybe she'll even have a helpful explanation or offer a reduced fee herself.
My midwives didn't clean up either. After a long labor, we ended up transferring and had a cesarean 12 hrs later, so my poor husband had to support me for three days, spend a day in the hospital, then leave us to clean everything up. He's still annoyed about it! I'm non confrontational, so I never did talk to them about it. There were some support issues, but they were at our house for a very long time, so my dh was more upset about it than me.
How much time was there between the "come now" phone call and her arrival? How far away does she live?
Leaving the house in such a state is completely unprofessional. I probably wouldn't argue for a lower rate, but I certainly would not hire her again or recommend her to anyone else. We're not talking about someone who accidentally left one bloody hand towel behind--we're talking about a mess that required two hours to clean up. Leaving behind that kind of mess demonstrates a lack of respect for you and your home, a lack of dedication to ensuring things are done correctly, no commitment to being detail-oriented, and a general lackadaisical attitude. Those are all terrible attributes for a midwife.
For 14 years I've been a home birth midwife. I've missed MANY births and I believe this is a two-way street. It's the woman/couple's responsibility to call me in time and it's my responsibility to get there in a timely fashion when I am called. As long as both sides did the best they could, the rest is up to fate and you can't "blame" anyone. As far as the clean-up...in almost 900 births I don't think I've ever had anyone ask me prenatally or post partum about the housekeeping situation. I'm unaware that this is considered a midwive's duty. Of course, I deal only with horse and buggy Mennonite women. As a midwife, I clean up any mess I have made. If the woman or couple threw some wet towels around before I got there, left their dirty clothing in a pile on the living room floor or left the bedroom strewn with empty gatorade bottles, I just don't think it's my duty to clean this up. It's interesting to hear the views of the women on this subject. It's also interesting to hear "...was this in the contract?..." as I do everything with a handshake and have never had a contract. It sounds like in this particular case there needed to be some more communication. Madeline, you should approach your midwife in an open way so that you can feel better about this because maybe it truly was a misunderstanding or maybe you will find your midwife really was remiss.
I didn't see where you said how long was between when you asked her to come and she arrived and whether the timing was made clear to you. I think a MW missing a birth is a reality, especially with a fast birth, if a family doesn't call in time or if the MW lives far away. The MW's distance from the family should be talked about at length during pregnancy and everyone should be prepared for how to deal with that. My last MW lives 5 minutes away but worked all over the state so I called her as soon as labor started to have her prepared and ready to come quickly when I called back with the "go". When we called back and said we were ready for her to come she communicated with us exactly when she would be there, when the assistant would be there and etc. This seems like a reasonable expectation. If my labor was crazy fast and happened before she was expected to arrive I would have dealt with that.
As far as cleaning, my MW's were pretty thorough but my DC's birth was late and I knew they had been at a birth before that so I sent them home. There was still some stuff to clean but they also knew that we had a lot of people around to help.
In your case it sounds like there are some red flags and I'm not surprised you're feeling unsupported by your MW. Speaking of two way street, a MW/client situation where the MW lives or works far from the home of the client, this is something she needs to be aware of too. That should be factored into when at what point in the labor you two decide she should come. And the cleaning, if that was part of the agreement AND she missed the birth...yea, I would think a little extra clean-up and postpartum care were in order.
Congrats on your sweet LO and I wish you healing thoughts as you process your birth.
Did you and your MW discuss how long from the point at which she thought she should start out to your house (considering how far away it was) before labor? Did she take longer than the amount of time you had discussed she would need to make your birth (and presumably hard labor, transition and the second stage!)?
One of the red flags for me is that I consider one of homebirth midwifery care to be one where the MW expects to be there for a good chunk of the labor. I know misses happen but if my MW lived an hour away I would want her to plan to err on the side of caution. Did you talk about that?
Did you give birth in less than an hour from the time you called the MW at ctx 10 minutes? The reason I ask is I wonder if maybe (maybe?) the MW did think she was erring on the side of caution and you had a really unusual ctx pattern? I have no idea about that but am just kind of wondering.
Also, you said you have a history of short labors? If that were the case I think I would want the MW to come from an hour away right at the start of labor.
Here's what I would want to know if I were you: Is "5 minutes apart" an appropriate marker for a MW living over an 1 hour away from a client having her 4th baby? At what sage of labor would a MW giving this marker expect to arrive for?
As far as the communication goes -- that sounds like your MW may have been a more "hands off" MW maybe when it came to guiding the birth discussion. I had one MW like that and thankfully that was for my second planned HB. It's a good fit if you know the ropes but obviously not a good fit for a first time homebirth mama like you.
I think you should just ask her if her birth fee will be included in her final price... if she says yes, I'd ask what that portion of the bill is covering exactly since she didn't make the birth OR clean up. Perhaps in your contract she states that her fee is non-negotiable, can't be prorated, yadeyayaya. You can't really blame her for missing the birth if she got there in a reasonable time frame after you asked her to come(like I know my midwife is an hour away if she's at home, so I'd anticipate an hour and 15 minutes tops for her to get her from the time I ask for her to come), anything dreadfully long I'd assume wasn't her planning on a fast birth and just taking her sweet time.
Regardless of missing the birth, they should've cleaned up the birth mess, like come on!