Hearts and Hands reminds us that most midwives today are grossly underpaid and underappreciated. Where once she would have cared for the whole community and its individual ailments and conditions and the community would have gladly paid her with everything she needed to survive, now she works long hours, drives vast distances, and earns something akin to minimum wage once travel costs and (wo)man hours are added up. That book even suggests that, where possible, clients of modern midwives pay above and beyond the suggested price to attempt to bridge the gap between salary and survival. A midwife gift is not only in good taste, but almost necessary after a good smooth birth well attended. After nine months of mother centered care, it is almost unimaginable that a happy grateful mother wouldn't feel the urge to give some sort of token of affection, admiration, praise, and/or thanks. As for ideas, I've heard many and the variety reflects the individual relationships created. I gave my midwife a headlamp from REI. I do work in the childbirth field myself and had grown so close with my midwife that we now share friendship and a certain professional report as well. The headlamp, a tool for cavers that includes an elastic strap for your forehead and one or more hands free light settings, just seemed like the perfect gift.
A client gave me a handmade item, and I simply treasure it so much!! I think of her and her sweet baby every time I wear it. 
