Do apprentices get paid?

[DoomaYula]

Or a stipend or something like that?

[Funny Face]

I too was curious about this. I thought I read somewhere that preceptors actually charge their apprentices... which would also make sense because the amount of extra work and teaching they are putting towards you... like a college professor.

Intersted to see the answer :

[teachinmaof3]

Some do...some don't.

[Reha]

:

It really depends. In my area, we do get paid for the most part....but just an hour south of me, I know apprentices who don't get paid (which is the norm down there). So, it depends.

I am very grateful to my preceptor for paying me, though.

[JunipersMom]

When I apprenticed - some midwives charged their apprentices.. so not only did they not get paid, but they had to pay to apprentice. Personally - I was an office slave to my preceptors so I did a ton of paperwork, filing, computer stuff etc.. along with the apprenticeship. I got $1 per birth that the midwives kept an account of and instead of paying me - they added it all up and bought me a doppler with the money instead. I think they wrote it off as a business expense

[Reha]

Originally Posted by JunipersMom

When I apprenticed - some midwives charged their apprentices.. so not only did they not get paid, but they had to pay to apprentice. Personally - I was an office slave to my preceptors so I did a ton of paperwork, filing, computer stuff etc.. along with the apprenticeship. I got $1 per birth that the midwives kept an account of and instead of paying me - they added it all up and bought me a doppler with the money instead. I think they wrote it off as a business expense

How many births did you attend with them, out of curiosity? Dopplers aren't cheap, and if I got paid $1/birth, it would probably take me like 4-6 years to get a doppler...

[JunipersMom]

I did about 80 births with that practice... the $1 a birth was accumulative.. 1st birth $1, 2nd birth $2, 3rd birth $3.. etc..

[blissful_maia]

I don't get paid, but I am studying through a Canadian university... don't know if that's different. I actually have to pay tuition and all my expenses (which are pretty huge in this extremely gigantic catchment area).

[shelbean91]

Sounds like student teaching- not only do you not get paid, but you have to pay a semester of full tuition. And, the teacher your teachign with still gets paid regular salary and a stipend.

[MidwifeErika]

The agreement that I have with my preceptors at this point is that I am not getting paid for now. Once I am able to be the assistant at the births (after I have completed phase 1 in the Becoming a Midwife workbook), then I will get the assistant fee.

[MsBlack]

This is an interesting topic for me...

I've heard various things from different apprentices over the years. Some have spoken of not only paying a few thousand $$ to their preceptor, but also being the office slave. For one of these, she said there was hardly time to attend prenatals or births because of the amt of time she spent doing filing, etc, after paying the apprentice fee too. Some have mentioned that it was an exchange--mentor's time for apprentices (in various supportive ways) and then getting paid some sort of stipend when becoming enough of a real help to be useful to the mw.

I just had my first apprentice, a relationship that ended suddenly after a few months (she quit). We had an exchange agreement--neither pd the other (well, she was entirely green, so I wasn't going to pay her yet), tho I did sometimes give her some gas $$ (if we used her car to travel to prenatals, as sometimes happened). This exchange seemed only fair at first, to me...then later I began to realize the time I was putting in, and the fact that in her case, she didn't have much to offer in return. I mean, she was smart and willing, and at births she did whatever auxilliary work (cook, wash dishes, etc) she was asked to do....she was not a slacker by any means, but being so green meant that she both had little to give of any serious importance, AND needed more of my time teaching/explaining/etc than a more experienced apprentice might have done.

So I'm not sure now, how this should go. There definitely needs to be some kind of exchange going on--the mentor IS working for the apprentice, IS putting in time and effort apart from just having the apprentice present. It seems unfair for an apprentice to pay a few thousand $$, AND be expected to do slave labor in a mw's office. And it is also unfair for the student to receive something of so much value from a mentor, without paying something for that. I am trying to figure this out, as I await the next apprentice candidate in my practice.

I know that for me, I did not sufficiently value my input to my apprentice, and she could feel this. In practice, this meant two things: One is that there were times I sent her long emails to explain something, or ask her to think about something, and she might basically ignore it, or barely reply...seemed she did not feel compelled to think about this stuff and did not, apparently, see how it might relate to our in-person work at prenatals and births. The other is that she tended to 'challenge' me on stuff--not just ask questions, but actually make strong statements about what she thought she should happen in some situation, contradicting what I was thinking/doing (not in front of clients, but it still impacted some of our client relations). Mind you, tho this woman was extremely well-read considering her newness to the work, she had only been to a few births in all, as an observer and sometimes labor support. It was not just what she would say, but how she said things that bugged me--and I think that I had simply not been clear enough on the boundaries, nor sufficiently demonstrated my own recognition of the value of my input to her learning. Well, I am pretty egalitarian, I didn't want to come off as a big heavy authority or anything. I tried to demonstrate my respect for her point of view, and I think that for her, this meant that I did not sufficiently respect my OWN knowledge and pov! Which is kinda confirmed for me since her timing of quitting was immediately following the first time I ever did get the least bit heavy with her (stated a criticism of something she did, and set a bottom line reqirement for addressing the problem--not angry or mean, it was just the first time I'd not been praising her!).

Anyway, in retrospect now, I do think that apprentices have to make some sort of good exchange with their mentor. In my mind it doesn't have to be cash, but it has to be of real value to the mentor. And I think that apprentices EVENTUALLY should get some sort of stipend (per birth, maybe), but only after they've become knowledgeable and skilled enough to actually be useful to the mentor.

[pamamidwife]

I have a few thoughts on this topic, as my apprentice and I were discussing it this morning...

For me, there are a variety of benefits to having an apprentice.

• Another set of hands at the birth. Even the most green apprentices can provide essential help in an emergent situation. Of course, it's nice when you don't have to ask for what you need, but in my experience, my apprentices have really had an intuition and stable calm during emergencies that was valuable. I'd rather have an apprentice next to me to ask to do things than an emotionally attached family member.
• Apprentices are learning - and this means that sometimes there are things that they are exposed to that I'm not. A new study, new research, another teacher's belief system - all these things challenge my ideas and my practice. Growth is good. I'm hungry for things that will enhance my practice, my knowledge base and my skills. Both apprentices I've had have provided this information to my practice.
• Teaching someone reinforces how I'm doing things. I'm not the best at always teaching OSHA requirements (sometimes I do things with no gloves, etc), but I talk about what I *should* be doing in order for it to be safer, proper technique, etc. This in and of itself keeps me reminded of my need to step up a bit and do what is required of me.
• Apprentices can help provide extra support to the mother, to siblings, spell me while I nap (depending upon their level of skill) during a long birth
• Apprentices are awesome to brainstorm with during long or difficult labors. I don't know how many quiet meetings I've had with my apprentices in another room or while taking a quick walk or a trip for coffee during a long labor...their ideas, feedback, suggestions are a lifesaver when things get fuzzy and tired.

MsBlack, when you brought up that the apprentice "challenged you", I wonder where the defensiveness came from. If you are doing something that you find sound and evidence-based, or just something that helps your comfort level, why get angry? Is there an idea that just because someone has only had book knowledge and not hands-on skills that she has no right to form ideas about practice? If so, I disagree. Sure, many midwives do things a certain way because of history (if you had a bad PPH after a long third stage, you might think that hurrying the placenta will help "prevent" it from happening again), but if she ultimately was talking to you in a way that was less than constructive perhaps THAT should have been addressed on your part....like how it made you feel, etc. (not that something was "wrong" with her).

When we feel that what we are doing is the right thing, soundly in our heart and mind, when challenged, we rarely feel angry and upset about it.

I agree that communication is key. My first apprentice was a total learning experience that didn't always go well - and I take full responsibility for that. I allowed my personal life and an untreated mental illness get in the way of what should have been occurring with her.

I find it helpful to create a contract initially. Line out expectations - and be specific! What will the new apprentice do at prenatals, births, postpartums. Do you expect attendance at all or just some appointments? Will she be early labor sitting? If so, what does that entail? After so many prenatals and births, will these expectations change? To what? Will there be a regular period of time for an exchange of 'checking in' - both on how the apprentice feels the apprenticeship is going, her needs; and the preceptor - what skills would she like to see added on to? what needs improvement (and I always find it helpful to hear from the apprentice first what skills she feels she needs more practice in rather than saying it to her - she usually already knows).

Line out payment. I pay my apprentices starting at $25/birth, then as responsibilities include (when she starts her primaries), I pay $100/birth, then $150/birth and when she's a full assist (has NRP, can do a birth on her own, etc), I pay $200/birth.

I pay apprentices because they have expenses. I require my apprentices to move to my city. This is hard because in my area, most student midwives are in Portland or Eugene (both an hour away). I want them to get adequate childcare so there's no worrying when we are at a birth about their kids. I want their gas to be paid for (because I have some apprentices take blood to the lab, do postpartum visits on their own, etc). Above all, I want them to know that I value them and their time - it's why I want to be paid as a midwife.

If I was someone's only source of learning, that would prove to be harder. But I honestly feel like it's not a strain on me to teach someone the art of midwifery. I get alot more out of it than most of my apprentices do, especially when it comes to expanded knowledge, challenges to my practice, and help. I can't even imagine charging an apprentice to be my apprentice. That concept seems so foreign in my situation.

There are always going to be situations in which someone's needs aren't going to be met - maybe there's an apprentice that needs constant praise and kudos. If your apprentice needs this, talk about it early on! I think that discussing honestly how each person feels about the situation will help. And in the end, if the relationship ends, it's probably for the best.

[pamamidwife]

Originally Posted by hotwings640

The agreement that I have with my preceptors at this point is that I am not getting paid for now. Once I am able to be the assistant at the births (after I have completed phase 1 in the Becoming a Midwife workbook), then I will get the assistant fee.

Can I just say how surprised I am that someone is still requiring that book? It's so outdated....and Erika, do you find that some of the stuff Carolyn proposes apprentices do to be really inappropriate and "slave-like"???

[MsBlack]

It was not about being 'angry' with the apprentice, but a growing sense of unease with the woman, with exchanges that led to mutual discomfort--yes, it was about the way she communicated. She had well-practiced habits of domination is the only way I can put it. She herself admitted that she had a need to be right, and would introduce things in a less than constructive way--challenges NOT just to events or methods, but to me as a person and midwife. An apprentice simply has to have an open mind and heart, and she did not--as evidenced by her quitting without preamble and no willingness to process at all, the first time I ever offered real critique.

We did attempt to process this stuff as it arose, and for awhile I thought we were having some success. But mainly I think that she had a very hard time being a student, a beginner--she was accustomed to being a leader in other things she'd done in her life, could not feel comfortable with this new role...and this led to her way of communicating in which she couldn't seem to help herself from asserting in a 'one-up' sort of way. I am a challenging person myself, and appreciate being challenged--but there is a difference between challenging someone in a constructive way and simply putting them down--however 'subtly'.

All of what was said about the value of apprentices is right-on, as far I'm concerned--very well said for sure!

And yes, apprentices do have expenses--the expenses of education, as far as I'm concerned. I paid for my own midwifery education, as I think anyone should.

More later, family calls.

[pamamidwife]

I totally understand what you're saying, MsBlack. Sounds like it was a personality conflict at least.

[MidwifeErika]

Originally Posted by pamamidwife

Can I just say how surprised I am that someone is still requiring that book? It's so outdated....and Erika, do you find that some of the stuff Carolyn proposes apprentices do to be really inappropriate and "slave-like"???

It is a little outdated, which is great because I was able to pick it up pretty cheaply on half.com We are doing kind of a mix of things, using this workbook as an outline, adding in all the stuff I need for NARM, pulling out the stuff that they don't use in their practice, adjusting everything to make it current, and then I have AAMI for the rest. Somedays my brain gets tired trying to think about it all.

Yes, I think that if I had to do all the stuff that apprentices are supposed to do for their preceptors from that book, it would really be too much. The list in that book is HUGE! Fortunately, my preceptors seem to think that list is too big as well and have asked me to do very little.... in fact, I am starting to feel guilty at how little I have actually contributed at this point in time.

[Maggi315]

This is always an interesting subject and one I always follow.

I think that when an apprentice is "green" and is requiring a large portion of the midwives time and energy (having someone follow you around all the time, having to explain everything, taking the time to meet before/after prenatals/births/postpartums, etc.)then, no, they shouldn't be paid. In my other life, I teach nursing students lab and clinical. They pay for that! They need to have child care almost full=time, come to work at clinical for 6+ hours, go home and write papers, research things, do projects and more. Each semester their schedule changes making a job difficult. many survive on either their husbands salary or if single, state aid, babysitting, newspaper routes, selling stuff on ebay, lots of creative means. It's a big sacrifice for something and takes total commitment. We see a good percentage drop out, it's very competitive too. And it is very much a challenging job to me to constantly have to explain things over and over. I love it, but it is work.

Midwifery teaching is no different, in some ways harder out in the homebirth field where one must be on their toes and be able to act responsibly and quickly. Having an apprentice means that the midwife must devote her attention to her clients, her family and her apprentice. That's alot of energy to give!

As the apprentice grows and can actually do more on their own and be more independent, I do feel payment is a fair trade off. Right now, I sometimes take my 17yo with me to births when another midwife can't come and she is a great help cooking, cleaning, getting me stuff, etc. And I pay her a small fee for that help.

I do have an apprentice who is just starting with me who is very experienced, a long time nurse and midwifery student, lactation educator. I expect to be paying her in another month or two because she will be able to answer questions, do some postpartum/lactation checks, draw blood, fill in for prenatals when I am somewhere else, etc. She isn't totally green and actually has alot to offer me, lots of knowledge, ideas, etc. So I am happy to pay her fairly for that experience and knowledge.

Great subject! Always lots to think about and ponder different points of view.

[MsBlack]

pamamidwife--

I wanted to get back to your earlier list, to comment on it (great stuff!). Also to ask a couple of questions....

****** "1. Another set of hands at the birth. Even the most green apprentices can provide essential help in an emergent situation. Of course, it's nice when you don't have to ask for what you need, but in my experience, my apprentices have really had an intuition and stable calm during emergencies that was valuable. I'd rather have an apprentice next to me to ask to do things than an emotionally attached family member."

Yes, definitely, on all counts. The thing is, how do you know if your apprentice will actually have that 'intuition and stable calm' that you mention, before such emergent moments happen? This is the very issue on which I offered critique to my apprentice...not even an urgent situation, but one w/neonate that required us to be 'on alert for developments'. Main thing needed was the clearing of the home of excess personnel, to give parents some quiet to understand the signs and make a decision about transport or wait-and-watch (in-laws had arrived w/young kids and some friends, a couple hrs pp, just before neonate's small issue was noted). Apprentice freaked out (in a quiet contained way) told me she was too scared, and had to leave (as I didn't need hands on help, and didn't want her fear in the room, I ok'ed this). We had a couple of preliminary and short discussions about this in days following, it was a couple of weeks until schedules allowed us to really sit down and chew on it. Which is when I said: "this is not ok--what if it really WERE emergent, and I really DID need you? You have to do something to prepare emotionally for this possibility" I tried to be firm but level with her...and as I mentioned before, had most often found ways to provide positive feedback and encouragement. I gave some suggestions, told her some stories of my experiences prior to midwifery that had both taught me some coping skills for tense situations and given me experience....her attitude was fairly lacksadaisical, like 'what does crisis training have to do with midwifery training?' Then she emailed her resignation. The baby, by the way, stayed home and was fine...the parents' initial fear dropped away as soon as house was clear and we could talk in the quiet...the 'early signs' never developed into anything.

******"2. Apprentices are learning - and this means that sometimes there are things that they are exposed to that I'm not. A new study, new research, another teacher's belief system - all these things challenge my ideas and my practice. Growth is good. I'm hungry for things that will enhance my practice, my knowledge base and my skills. Both apprentices I've had have provided this information to my practice.

Yes, absolutely. And still--all knowledge is a) formed from a point of view--so I don't accept all 'new research' before I've considered the point of view it arises from, and decided if it fits for me/my understanding of things (gbs research fits here). And b) all intellectual ideas have to be tested in reality to prove their worth. So, someone with little experience MIGHT tend to lean a lot on that intellectual knowledge and use it as a foundation for self-esteem...and not be so open to having that knowledge tempered by practical experience, not realize how intellectual knowledge is merely one part of the picture. Not sure if I'm saying this well...

*******"3. Teaching someone reinforces how I'm doing things. I'm not the best at always teaching OSHA requirements (sometimes I do things with no gloves, etc), but I talk about what I *should* be doing in order for it to be safer, proper technique, etc. This in and of itself keeps me reminded of my need to step up a bit and do what is required of me."

Yes, again, absolutely. This is one reason I love to teach.

******"4. Apprentices can help provide extra support to the mother, to siblings, spell me while I nap (depending upon their level of skill) during a long birth. Apprentices are awesome to brainstorm with during long or difficult labors. I don't know how many quiet meetings I've had with my apprentices in another room or while taking a quick walk or a trip for coffee during a long labor...their ideas, feedback, suggestions are a lifesaver when things get fuzzy and tired."

Yes again, definitely on the 'providing extra support' part...and again, the apprentice has to be experienced enough to read signs calmly, and able to apply knowledge to practical matters, to be really worthwhile as a brainstorming partner.

Certainly, 2 things have to be considered 'fundamentals' of apprentice/mentor relations: one is, the apprentice has to have a nature that is well-suited to the work, to the emotional responsibility involved; the other is that the apprentice and mentor have to have fairly well-matched personalities to be able to communicate and otherwise work together well. I definitely found my first apprentice experience to be valuable in the learning department...but I'm really not sure how to determine sufficiently at the outset, just which candidates DO have the necessary 'emotional equipment' for midwifery in general, and for apprenticing in particular--and, someone who WILL communicate and otherwise get along with me well enough for us to be a good match. I'm definitely looking for intelligence, assertiveness, self-confidence in an apprentice, and happy to support that in word and deed (just as I do for my moms/fams)--NOT for a humble sycophant or slave! But it does seem that figuring out the balance of things is not easy.

Thanks all for thoughts on this!