These things have been on my mind a lot lately, and I'd like to hear comments from both other midwives and consumers.
I feel like I've been giving my clients too much of myself. I'm having to crack down, set some rules, and build some boundaries. In our practice we have been doing all home visits, pretty much anywhere in a 2 hour radius (my partner lives an hour from me so we can spread ourselves out that far), any time that the clients preferred. My partner (an old country midwife) and I have had several discussions about what being a midwife means in terms of service to our clients, and we are now splitting our practice because we each feel that we need to offer different things.
I'll give you an idea of what we've been facing: We took on a client who lived 90 minutes away from me. I was used to that. She worked in a factory and claimed she could not take time off for an occasional one hour prenatal appointment. That was workable since I did keep Monday evenings until 8 open for evening appointments. However, they wanted to make their appointments for 6 or 7 pm, which meant that I would not get home until around 10:00 pm. The other option they offered me was weekends. That meant at least 4 hours of the only day I have set aside to be with my family. I had to bow out and let my partner find someone else to assist her.
So I'm making some changes.
Home visits: If they live in town, I will come to their home for a consultation. If they hire me I will provide the customary 36-week home visit, and home visits in the first week postpartum. Otherwise they will be coming to my brand new office in my home. Home visits are just NOT an efficient use of time. One day I went to see a client who lived 45 minutes from me. There happened to be a road block which added an extra 30 minutes. We had a regular one hour appointment, but she needed lab work that I did not have supplies for. It was quicker to drive to the lab for new supplies than go back to my house, but that was an additional 30 minutes each way. I take the lab sample, another 30 minutes back to the lab, and an hour and fifteen minutes back home. That's 5 hours for one appointment, and that's only the cost of my time on that occasion. There are other things that I need to do with my time. This summer I had to pay someone to mow my yard because it never failed that the sunny days were the ones I was out driving all over the country. I have a little side business selling herbs; this year a lot of my plants went to seed or rotted because I didn't have time to harvest them. My border collies were destroying my house because they were missing their daily agility sessions. Also, I have to have more frequent visits to the chiropractor and massage therapist when I spend all my time driving in the car. That adds up. Do I even need to mention the cost of gas?
Office hours: no more bowing to the client's schedule. I have office hours: Monday 12-5, Tuesday 10-3, with spillover on Thursday 10-3 , or on Friday if absolutely necessary. I don't see clients on Wednesday. That's my day for taking care of my personal appointments. I don't do evenings or weekends unless there are special circumstances. This is actually largely to having other engagements at those times; I used to cancel or miss them because that's when clients needed their appointments but then I realized how important those events were to me and how I was missing out on my life because of my work schedule (or lack thereof). My husband used to have a job that kept him away from home until late at night; when he had to find a new job he limited his options only to ones that would let him be home nights and weekends. It's only fair that I do the same.
It drives me nuts when clients say "I want to miss as little work as possible, can we have our appointments at night?" I want to miss my family as little as possible, and I've got to stick up for my rights and priorities. I tell them "When your baby is due, you are my top priority. When you are in labor, I am prepared to miss days of family time, including important family events, to attend to your needs. All I ask in return is that you respect the time I am able to make available to my family."
I know I'm probably coming across a little harsh (it has also come to my attention recently that I'm spending WAY too much time carefully composing my emails and posts; I'm trying to be more efficient by just saying what I need to say). But I'm wondering how you other midwives so it, and what clients expect of their midwives versus what is reasonable for a midwife to offer.
I feel like I've been giving my clients too much of myself. I'm having to crack down, set some rules, and build some boundaries. In our practice we have been doing all home visits, pretty much anywhere in a 2 hour radius (my partner lives an hour from me so we can spread ourselves out that far), any time that the clients preferred. My partner (an old country midwife) and I have had several discussions about what being a midwife means in terms of service to our clients, and we are now splitting our practice because we each feel that we need to offer different things.
I'll give you an idea of what we've been facing: We took on a client who lived 90 minutes away from me. I was used to that. She worked in a factory and claimed she could not take time off for an occasional one hour prenatal appointment. That was workable since I did keep Monday evenings until 8 open for evening appointments. However, they wanted to make their appointments for 6 or 7 pm, which meant that I would not get home until around 10:00 pm. The other option they offered me was weekends. That meant at least 4 hours of the only day I have set aside to be with my family. I had to bow out and let my partner find someone else to assist her.
So I'm making some changes.
Home visits: If they live in town, I will come to their home for a consultation. If they hire me I will provide the customary 36-week home visit, and home visits in the first week postpartum. Otherwise they will be coming to my brand new office in my home. Home visits are just NOT an efficient use of time. One day I went to see a client who lived 45 minutes from me. There happened to be a road block which added an extra 30 minutes. We had a regular one hour appointment, but she needed lab work that I did not have supplies for. It was quicker to drive to the lab for new supplies than go back to my house, but that was an additional 30 minutes each way. I take the lab sample, another 30 minutes back to the lab, and an hour and fifteen minutes back home. That's 5 hours for one appointment, and that's only the cost of my time on that occasion. There are other things that I need to do with my time. This summer I had to pay someone to mow my yard because it never failed that the sunny days were the ones I was out driving all over the country. I have a little side business selling herbs; this year a lot of my plants went to seed or rotted because I didn't have time to harvest them. My border collies were destroying my house because they were missing their daily agility sessions. Also, I have to have more frequent visits to the chiropractor and massage therapist when I spend all my time driving in the car. That adds up. Do I even need to mention the cost of gas?
Office hours: no more bowing to the client's schedule. I have office hours: Monday 12-5, Tuesday 10-3, with spillover on Thursday 10-3 , or on Friday if absolutely necessary. I don't see clients on Wednesday. That's my day for taking care of my personal appointments. I don't do evenings or weekends unless there are special circumstances. This is actually largely to having other engagements at those times; I used to cancel or miss them because that's when clients needed their appointments but then I realized how important those events were to me and how I was missing out on my life because of my work schedule (or lack thereof). My husband used to have a job that kept him away from home until late at night; when he had to find a new job he limited his options only to ones that would let him be home nights and weekends. It's only fair that I do the same.
It drives me nuts when clients say "I want to miss as little work as possible, can we have our appointments at night?" I want to miss my family as little as possible, and I've got to stick up for my rights and priorities. I tell them "When your baby is due, you are my top priority. When you are in labor, I am prepared to miss days of family time, including important family events, to attend to your needs. All I ask in return is that you respect the time I am able to make available to my family."
I know I'm probably coming across a little harsh (it has also come to my attention recently that I'm spending WAY too much time carefully composing my emails and posts; I'm trying to be more efficient by just saying what I need to say). But I'm wondering how you other midwives so it, and what clients expect of their midwives versus what is reasonable for a midwife to offer.
