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#31 of 52 Old 05-01-2012, 05:04 AM
 
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I do consider myself a guest in my clients homes, as far as food goes. Sometimes I am at a womens home for 2 or 3 days. It's not a hospital where I  take a break & go to the cafeteria, & many of my births are way out in the country, w no 24 hr restaurants nearby. While I  don't expect a laboring mom to wait on me, I do expect there will be nutritious food for all in attendance, I have gotten terrible headaches in the past from not eating at births, so  I have added "nurtitious foods" to the supply list. I never know where I'll be or how fast I have to leave for a birth, so it is impossible for me to have a 3 day supply of food always handy. I do keep snacks in the  car though.
  I never accept money for work I haven't done yet, but do expect a $25- $100 payment at each (or at least most) visits (depending on how far a drive it is) so that about half is paid up by the birth. With the remaining due at the birth or pp visit. A lot of midwives due expect to be paid in full before the birth though. I think that is more the norm than how I handle it.

I do expect full payment even if they come to care late, since we have the same amt of preparing to do, just less time to do it in.  If they have been getting GOOD quality care (not just typical ob 5 minute visits) from someone else who's teaching/care I trust I do not have to unteach or reteach, then I give them a discount for the care they already received.
I do expect to be paid in full, even if I miss the birth, through no fault of my own, But usually forgive the last half if they end up  with a hospital bill to pay. Not because I don't deserve it. After all, getting complications to the hospital in a timely manner is an important part of my job. Rather because I know how devastating a hospital bill can be! (it took us well over 10 yrs to pay for our baby who spent 4 days in NICU!)   If I miss a birth because I am at another birth, then the remaining money goes to the midwife that covered for me.
 

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#32 of 52 Old 05-01-2012, 10:24 AM
 
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JMO... It strikes me as one of those things, like wedding gifts.  According to Miss Manners (with whom I agree), as a bride/groom, you're never really supposed to expect a wedding gift-- that's not why you're getting married nor why you are inviting people to share in your joy.  At the same time, as a guest, if you feel so emotionally moved to attend a wedding, you should feel similarly moved to give a gift (dollar amount completely unimportant, could be a personal item of $0 intrinsic value, etc.-- but something).

 

With HB MWs and food...  I think it's A) highly tacky for a MW to demand food (tone is everything), especially really specific foods (outside of maybe mentioning one is vegan, kosher, allergic to peanuts), but also B) kind of inconsiderate (under normal circumstances) not to provide something for the MW, somehow, especially during a labor longer than 6-8 hours (which cannot necessarily be predicted).  Just like a bride shouldn't demand or even really expect a present (imagining it's a guest's obligation), but a guest who brought or gave nothing would be kind of out-of-line, too.    

 

And although I agree I'd most definitely chafe at anything close to a demand for highly specific foods, I also agree with PP that this is not like most jobs, where people can take some sort of break or at least have access to a vending machine or something.  I consider the extra, what?, $5, 10, 20+ and 2 extra minutes at the grocery store to grab peanut butter, bread, apples, whatever, a part of my MW's fee, in a way.  shrug.gif


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#33 of 52 Old 05-02-2012, 06:49 AM
 
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As far as the food list goes, I would find it a little insulting that the midwife would feel the need to tell me that there should be food in my home. I know the area I live in and how close restaurants are, and I'm already aware that humans need to eat. If they want something really specific they'll bring it or order out. Maybe I'm getting a little hormonal but I don't think I would like that either. If it were worded differently like "in the past I have found that some convenient foods to have on hand for family and attendants include..." I wouldn't mind. I wouldn't like to be "required" to have a certain kind of chocolate for her though, unless she explained why that is important to have at births.

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#34 of 52 Old 05-02-2012, 03:35 PM
 
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Marlene's post DID open my eyes a bit and make a decent point.  I live in an urban area where you're never far from dozens of eateries.  I'm working with a large OOH midwifery practice in a MW-friendly state with plenty of back-up help.  So there's a lot that I can take for granted here. 

 

I STILL think that if you're a midwife and know that you'll be on call for a given week, or that one or more of your clients are at term, it's not unreasonable to keep a cooler well stocked with goodies so that you're ready to take responsibility for your own needs in this area.  I hold to that.  But I can also see where feeding yourself would present challenges if you're serving a rural area or working in a state in which midwifery is illegal and you have to operate underground. 

 

The reason I feel strongly about this is pretty simple.  I know first-hand what all goes into prepping for a homebirth.  It's the third trimester, so you're huge, moving slowly, and running around town--often with other small children--finding used towels, sheets, and other necessities on that shopping list that your midwife gave you.  Many women feel pressure to keep their house clean for the Big Event, (and some MWs request it!), but it's hard to have it CONSTANTLY immaculate for an event with an unknown and unpredictable "start time." 

 

Then AFTER the baby is born, far too many women are under pressure to entertain all of the extended family and other visitors who crash in on her.  I'm gearing up for my third baby now, so I've drawn some much better boundaries.  But to this day, my blood pressure rises when I remember having my first baby.....all of the impromptu family reunions happening under my roof during those crazy post-partum days.  It didn't help that everybody's definition of "helping" me was holding the baby, (um, thanks, but that's the one thing that I CAN actually do eyesroll.gif).  Meanwhile, they'd leave the house trashed, and I'd be trying to pick up after them while praying that my stitches didn't tear as I stooped down to clean up their crap! irked.gif

 

I'm starting to wander here, so I'll get to the point: If a MW requests little nibbles and noshes because there's absolutely no other way to get food, that's one thing.  But she should have a LEEEEETLE bit of empathy for what her pregant and post-partum clients are *already* going through.  With all of the stresses of labor, childbirth, and post-partum recovery, she shouldn't expect her client to go to heroic lengths to play hostess for her. 


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#35 of 52 Old 05-04-2012, 02:31 PM
 
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As many previous posters have said, I would guess that this has more to due with a poor connection with the midwife, than the specifics around the care.  If I am comfortable with someone, and we have a good relationship I am likely to hear "wholesome soup, cheese and crackers, nuts, fruit and dark chocolate" as "just keep something simple and nutritious around, but don't worry about a homecooked meal".  If I am not comfortable or put off by them in general I'll hear "here's my outlandish requests for you, better get me my snacks or I'll be upset".  I would not be surprised to find out that in the past she's encountered both a scenario where there was nothing nutritious to eat, and a scenario where the mom went way overboard preparing extravagant food.

 

My midwife listed "snacks for midwives, birth-attendants, doulas, and guests" on the list of birth supplies I should gather.  There's nothing specific.  I personally feel comfortable providing a meal to the birth team, and it would make me happy to be able to do so.  That being said, I would also expect the birth team to plan ahead for their own needs to some extent.  I read a post somewhere about a midwife requesting coffee.  We don't drink coffee in my house, but if I knew my midwife really liked coffee, I might try to have some instant coffee on hand.  If she wants a latte, well I hope she knows where Starbucks is.  My home visit ended up having to be pushed back a couple of hours, and was right at dinnertime.  When my midwife arrived we had just sat down to eat dinner.  It felt really good to me to be able to invite her into our home, and have her sit down to a meal with us.  Birthing is an intimate experience, and although I am paying her, I think there's more to it than a normal money for a service relationship.  It's an interesting crossover between a personal and professional relationship.  I know way more about my midwife's personal preferences, and personal habits than I would about a doctor.  Not in an unprofessional way, but we have spent months building a relationship.  

 


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#36 of 52 Old 05-06-2012, 12:09 AM
 
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If she misses the birth because you can't get ahold of her is one thing. If she is on the way or her backup is on the way, and the baby comes, she will still be available to you for all of the immediate postpartum and newborn stuff. This is how she makes a living. Sometimes birth is fast. 

 

As far as food, you aren't on call for one week, you are on call for five weeks, or longer if needed. Keeping a cooler stocked makes no sense to me. Yes, I can have food for myself, and do try to pack snacks and things, but if I quietly grab a peanut butter and jelly sandwich at three in the morning after being up for 27 hours, I would hope that no one would mind. I don't have anything on my birth kit list, and honestly I think it is weird that your midwife is so particular, but who knows. You should ask her why she is so specific. 

 

And the fee is the same regardless of when a family comes in. Our responsibilities don't change. However, there are always exceptions as needed. 


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#37 of 52 Old 05-09-2012, 01:20 PM
 
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Such specifics about food are a bit silly.. I would be gracious and have something but you should be concerned first about your labor! Not what the midwife eats. Also it is customary to pay the prenatal care fee. She has made a 24/7 commitment to you and it's not her fault if you don't keep your appointments. Also she has time and education that need to be resprcted. If you went to a dentist you would expect to pay. Midwives, CNM , have 7-8 years of education respect that.... It's very difficult to practice and have the $ thing as an issue for a midwife. Also if she can't make it she would pay for qualified back up. I would think. Finally I'm not sure why this is happening between you two. Please talk to her and clarify all this with your midwife or her office mgr. so often I see comments and remarks on this site and the midwife deserves a chance to explain. Most of the time it can easily be resolved.
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#38 of 52 Old 05-09-2012, 01:56 PM
 
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if you're not 100%, choose a different midwife.  


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#39 of 52 Old 05-20-2012, 03:26 AM
 
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Please,Please,Please, go to naval gazing midwife. Her website is a refreshing breath of truth. Midwives are not accountable to anyone...especially read the questions to interview.You should get a reasonable refund when appropriate.3000. is way way way tooooooo much to pay a beginning midwife. She needs an senior midwife at all births. The best sales ladies are not not not the best midwives. We've all got to think again...myself included.I've attended1000+ home births and always fed myself, thank-you. But there are so much more important questions.Love you new families...may God bless and prosper you.

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#40 of 52 Old 05-20-2012, 11:53 AM
 
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Food For the Midwife

 

I take real issue with this.

 

Your midwife is not sitting at home, waiting for you to call when you go into labor. She likely could have been at another birth, for many hours, been at prenatals all day, visiting a postpartum family or a dozen other scenarios. A midwife is not like a construction worker at your home or a banker or any such thing. She lives her life on call, 24 hours a day. She does not get 8 hours of sound sleep every night, nor do laboring women labor and birth from 9-5. Comparing a professional who works on call (midwife) to a professional 9-5er (banker, construction worker) is a very poor comparison, at best.

 

I find it cold and shocking that some of you feel that it is rude for a midwife to request food be available to her during your labor. (I do however understand that in some locales it is not common practice for a midwife to request food.) It is a courtesy and just the right thing to do for a pregnant woman to have something nutritious available to her midwife. What if she has been at another labor for 12 hours and comes straight to your labor and is there for 12 hours? Do you really expect her to not eat, or eat dried nuts and fruit for 24 hours? Many towns do not have drive-thru fast food open 24 hours. Many women would feel abandoned if their midwife left them while in labor to go get food. Many women labor so quickly that a midwife does not have time to stop for food between births. Many women live very far from any sort of amenities.

 

How hard is it to have some nutritious frozen burritos or cans of soup for your midwife? Those can be bought weeks before your due date. I have hired many different midwives over the years and most of them do request some sort of nutritious food be available to them. I have never been insulted, rather, I was pleased for the opportunity to feed them something they find satisfying and enjoyable.
 


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#41 of 52 Old 05-20-2012, 02:20 PM
 
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I STILL think that if you're a midwife and know that you'll be on call for a given week, or that one or more of your clients are at term, it's not unreasonable to keep a cooler well stocked with goodies so that you're ready to take responsibility for your own needs in this area.  I hold to that.  But I can also see where feeding yourself would present challenges if you're serving a rural area or working in a state in which midwifery is illegal and you have to operate underground. 

 

 

 

IMO, this is ridiculous. A midwife isn't on call for one week JUST around YOUR due date. Most midwives begin their 24-hour availability for YOUR birth at 36-37 weeks and continue to 42-43 weeks. That's 6-8 weeks of 24-hours on call just for YOU. Midwives, as a general practice, have more than one client due in a month, and more than one client per year. Your average homebirth midwife is on call 24 hours per day, 365 days per year. Expecting a midwife to keep a cooler in her car "well stocked" 365 days a year is simply unreasonable.


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#42 of 52 Old 05-26-2012, 04:52 PM
 
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On the food issue... I also live in a MW friendly state, in an urban area with easy access to grocery stores and restaurants, and although I was initially turned off by the idea (I'm paying her, right?), I quickly realized how unreasonable my gut reaction was... especially in light of how cheap midwifery is when compared to hospital birth. I also had to pay for all of my birth supplies...

 

I eventually came to see it like this: if I wanted everything included in my birth package, I'd have gone to a birthing center. But I wanted a DIY-type birth, so I hired an employee (a midwife) to attend my birth. If I'd hired an employee for anything else (moving, administrative work, etc), I'd be obliged to provide breaks and not keep her there for more than 8 hours without paying her over-time, and giving her the option of going home and being replaced by a relief worker who I'd never met before. That's what happens in hospitals. My home birth was nothing like that... that was the point.

 

Maybe it's the labor economist in me, but I think that if you want to treat an employee like something other than an employee (by denying them breaks, etc) there's got to be a trade-off. I see meals (whatever they want - lobster, chocolate truffles, etc. - although in my case it was homemade lasagna and flan), a place to rest, and basically anything else she needs as part of that. I also made gifts for my midwife team (one very expensive and thoughtfully chosen gift and one painstakingly hand-crafted gift for each of three of them, actually). Yes, I also paid them $3500... but if I'd been in a hospital, it would have been three times that, at a minimum. I think people forget how much medical care costs if they are insured and don't pay for it out of pocket.

 

I have heard horror stories of midwives that were not kind, considerate or that didn't do their jobs. I wanted to make sure that mine were appreciated, whether my birth went the way I wanted it to or not. After all, I wasn't willing to go UC, but I wanted to have my birth my way... and as it turned out, that's exactly what I got. I don't know about the rest of you, but for me that's priceless (and this is coming from a solo mom who was a full-time student, part-time worker and who scraped and scrounged and did without to make sure this was the number one top financial priority short of putting a roof over my head). But, you know... that's just me. 

 

Edited for spelling.

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#43 of 52 Old 05-28-2012, 05:31 AM
 
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1. Is it customary for midwives to ask for the full payment even if they do not make it to the birth or cannot for extenuating circumstances like a car accident?
If no one in the midwifery practice can make it to the birth, then they usually subtract the birth costs from your total bill. However, if they send another midwife from the practice then yes, they usually, and should, charge the full amount.
 

2. Is us customary for a midwife to provide a list of foods for her to have at the birth? Do your midwives ask to provide foods? I guess it's common since to have food on hand for everybody but at the same time for the midwife to pack a lunch too. Mine is asking for wholesome soup, cheese and crackers, nuts, fruit and dark chocolate. Such specifics kind of turned me off!  I'm sorry, but I'm not providing chocolate!
I think some of those foods might be for you and daddy as well :). I know my midwife for my birth center birth asked me to bring dark chocolate, energy waters, etc. I also got a homebirth list(it was on the same page..) which had different foods to have on hand. I would definitely have food on hand for the midwife(and all birthing professionals and guests at the birth) just as a courtesy. If we get a homebirth with #3, I hope to be able to have a nice, delicious breakfast(or whatever meal should come at the time) for all those who helped make such a life changing event possible :)


3. Do midwives charge their full fee even if they start seeing a client during their 5'th month? I've missed at least three appointments in the grand spectrum.
They usually include prenatal visits in their full fees, so I would ask if they could prorate it for the appointments missed. An OB wouldn't charge you for prenatal visits you didn't go to, and neither should the midwife. 

 


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#44 of 52 Old 06-01-2012, 09:46 PM
 
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Most midwives begin their 24-hour availability for YOUR birth at 36-37 weeks and continue to 42-43 weeks. That's 6-8 weeks of 24-hours on call just for YOU. 

Uh, if your midwife is planning to attend you at home before 38 and after 42 weeks, you've got bigger problems than thinking about how to feed her.


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#45 of 52 Old 06-01-2012, 10:17 PM
 
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Uh, if your midwife is planning to attend you at home before 38 and after 42 weeks, you've got bigger problems than thinking about how to feed her.


Really?  I think it's pretty standard for most homebirth midwives to be comfortable delivering at 37 weeks. 

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#46 of 52 Old 06-02-2012, 12:53 PM
 
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Uh, if your midwife is planning to attend you at home before 38 and after 42 weeks, you've got bigger problems than thinking about how to feed her.

 

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Really?  I think it's pretty standard for most homebirth midwives to be comfortable delivering at 37 weeks. 

Um yeah, its also my understanding that 37 weeks is pretty much standard for where I've lived (in both OR and CA). Is it different where you live Katie? 


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#47 of 52 Old 06-02-2012, 01:31 PM
 
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The following three questions have been concerning me and preventing me from feeling 100% about my midwife. What are your midwives policies? What's the norm here?

 

1. Is it customary for midwives to ask for the full payment even if they do not make it to the birth or cannot for extenuating circumstances like a car accident?

 

2. Is us customary for a midwife to provide a list of foods for her to have at the birth? Do your midwives ask to provide foods? I guess it's common since to have food on hand for everybody but at the same time for the midwife to pack a lunch too. Mine is asking for wholesome soup, cheese and crackers, nuts, fruit and dark chocolate. Such specifics kind of turned me off!  I'm sorry, but I'm not providing chocolate!

 

3. Do midwives charge their full fee even if they start seeing a client during their 5'th month? I've missed at least three appointments in the grand spectrum.

 

 


This is my fist experience, but:

 

1.  My MW will prorate it for me if she doesn't provide some of the contracted services. But she also gives a discount of $300 if you pay in full by week 36. Not sure if she would refund if she doesn't make it to the birth for some reason. She's anywhere from 40 min to 2 hrs away, depending which office she's at when I go into labor and we have had snow, esp toward her main area in Nov.

 

2.  She just said to have food for her and any one else that would be there and that she's a vegetarian.

 

3.  Not really sure on that one since I saw her first at 10 weeks and should make the appointments overall.


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#48 of 52 Old 06-02-2012, 02:16 PM
 
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Uh, if your midwife is planning to attend you at home before 38 and after 42 weeks, you've got bigger problems than thinking about how to feed her.

 

Here in Oregon, midwives are allowed to attend homebirths from 35 weeks on if they consult with another licensed practitioner and from 36 weeks on without needing consult.

 

36-37 weeks is considered full-term, so I'm wondering why you're not comfortable with it before 38 weeks?


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#49 of 52 Old 06-02-2012, 04:39 PM
 
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Here in Oregon, midwives are allowed to attend homebirths from 35 weeks on if they consult with another licensed practitioner and from 36 weeks on without needing consult.

 

36-37 weeks is considered full-term, so I'm wondering why you're not comfortable with it before 38 weeks?

First off, <37weeks is considered late preterm. Babies born between 34 and 36+6wks are at higher risk for hypothermia, hypoglycemia, several types of respiratory distress including apnea, jaundice, and intraventricular hemorrhage. They are more likely to need resuscitation, including intubation. There are also some worrying conditions that can cause a woman to go into labor early- like a placental abruption, or infection. Oregon midwives are allowed to practice without a license, so I don't really take Oregon as a shining example of responsible practice.

 

I'm not comfortable with it before 38 weeks because at that GA, dates being off by a few days can make a significant difference in the baby's condition. And many/most homebirth clients are not the type to have gotten a first trimester ultrasound date. 


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#50 of 52 Old 06-02-2012, 05:57 PM
 
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Uh, if your midwife is planning to attend you at home before 38 and after 42 weeks, you've got bigger problems than thinking about how to feed her.

Your above comment was super jabby. 

 

I see you are in CA - and there the SOP for homebirth midwives is starting at 37 weeks. I lived in the Bay area and Santa Cruz for some time and I'm pretty familiar with a lot of the midwives that practice in that area. I understand you are not comfortable with doing it before 38 weeks - but that's you.  

 

You do know that most midwives in CA are comfortable at 37 weeks, right? Just to be clear -- 38 weeks is your opinion --- not the standard of care in California.


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#51 of 52 Old 06-02-2012, 09:43 PM
 
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Originally Posted by Thyme Mama View Post

Food For the Midwife

I take real issue with this.

Your midwife is not sitting at home, waiting for you to call when you go into labor. She likely could have been at another birth, for many hours, been at prenatals all day, visiting a postpartum family or a dozen other scenarios. A midwife is not like a construction worker at your home or a banker or any such thing. She lives her life on call, 24 hours a day. She does not get 8 hours of sound sleep every night, nor do laboring women labor and birth from 9-5. Comparing a professional who works on call (midwife) to a professional 9-5er (banker, construction worker) is a very poor comparison, at best.

I find it cold and shocking that some of you feel that it is rude for a midwife to request food be available to her during your labor. (I do however understand that in some locales it is not common practice for a midwife to request food.) It is a courtesy and just the right thing to do for a pregnant woman to have something nutritious available to her midwife. What if she has been at another labor for 12 hours and comes straight to your labor and is there for 12 hours? Do you really expect her to not eat, or eat dried nuts and fruit for 24 hours? Many towns do not have drive-thru fast food open 24 hours. Many women would feel abandoned if their midwife left them while in labor to go get food. Many women labor so quickly that a midwife does not have time to stop for food between births. Many women live very far from any sort of amenities.

How hard is it to have some nutritious frozen burritos or cans of soup for your midwife? Those can be bought weeks before your due date. I have hired many different midwives over the years and most of them do request some sort of nutritious food be available to them. I have never been insulted, rather, I was pleased for the opportunity to feed them something they find satisfying and enjoyable.

 
I completely agree thyme mom. Although its probably a moot point, since the dark chocolate was most likely for OP, I don't see why I wouldn't want to shower my midwife lavishly with tea, cookies, Brie, whatever the heck she wanted.
My midwives spend hours with me, just listening to my needs, perhaps you are not getting this same level of care OP?
Since I am in California, my midwives charge a lot of money to attend my birth. Do I think it is adequate pay? No way! I wish I could pay them so much more, or better yet, i wish they could get the same Pay as the hospital.

I feel like the client/midwife relationship has to be one of equal respect. And you know what, I want my ladies worrying about the oxygen tank, not their lunch pail.
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#52 of 52 Old 07-03-2012, 04:42 PM
 
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I guess one thing about the specific foods request that might be off-putting is that it was in the contract.  I feel like verbally requesting, or even on some later sheet running down the "preparing for your birth" stuff, might have been a more pallatable way to request a decent meal be available.  I too can get hung up on things that feel like they're requirements vs. requests.  This might be an ego thing, but I wanted you to know I'd also feel weird about it.  Probably because I would have (and have) gone very rediculous lengths of times without eating much because I didn't like the options available or feel like leaving my post was a good idea (and know midwives and doulas who also have/do).  It might be a poor self-preservation trait, but I wouldn't be able to ask a pregnant/laboring woman for soup, crackers, cheese, nuts and chocolate.  "Food" is one thing, soupmaking and hiding the stash from my munchie husband is another.

 

I also find it strange that a midwife would charge her full fees if she didn't make it to the birth, but on the other hand I don't know any midwives who are making a killing while doing little work, so I suppose if that's the best way for her to make sure she's fairly compinsated, so be it.

 

One last thought:  I attended a friend's homebirth not as a birth professional, but as a go-to of sorts.  I was there in case her other children woke in the night and needed anything, and I also made pancakes for the birth team and family when food was called for.  Although I didn't get to see anything, being around that energy was exciting and being included was an honor (think bridesmaid).  Perhaps a friend would be willing to play this roll for you?  FWIW, she called me at the same time she called the MW, and I dozed on the couch through the night, so she really didn't have to do a thing for me, least of all pay me. 


Humbly parenting Abraham (1/08), learning to be gentle and creative.  At least I got a good man to hold my hand.  Married to Ben (8/06). 

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