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Not 100% about my midwife.

5K views 49 replies 39 participants last post by  VTmamadownsouth 
#1 ·
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.
 
#2 ·
1- do they have a backup that would be replacing them?

2- yes it is fairly common for a midwife to ask for food to be available for them and specifying what is best for them doesnt seem weird to me.

3-depends on the midwife

if you are not comfortable with her i would suggest finding another midwife.
 
#3 ·
1. My mom (a midwife) spent years not getting paid at all for some births. Then she changed her policies to make sure she at least covered her bills she did requier full payment up-front but always provides a replacement if you did pay in full. Maybe think about with holding the last bit of money till labour (if you do choose this midwife that is). Most midwives will show up to a birth if you tell them "I'm in labour and I have cash right now".

2.I have never heard of a midwife wanting the mother to provide food for the mifwife. We keep chocolate at births to help raise blood sugar and a tierd mom gives birth but it's deffinately odd for the midwife to want food for her.

3.Yes alot of midwives charge thier full fee even if you started care with them a little late. Your first few appointments will prob. take longer then the norm at that stage to get her caught up with your info. and blood work (if needed).

Happy midwife hunting and rem. she's not interviewing you, you're interviewing her! Have a grateful birth.
 
#4 ·
None of those things would bother me. She's probably ended up with each policy via her experiences, such as being at a birth for thirty hours and discovering that there was no decent simple food on hand a few times...

I have known of midwives to create a cost breakdown for prenatals and the birth so that technically you could get discounted for a few in some situations, but I wouldn't expect it necessarily. I switched to a midwife in my seventh month and paid in full. And even though our fourth child was born before the midwife arrived (she was stuck behind a rural school bus at 3:00 pm) she still came and she did the cleanup and the postnatal visits and it would not have been fair for her to lose her fee on that birth.

The payment in full isn't shocking. Midwives have to spend several weeks on call for every client, they have to schedule those on-call times so they don't overlap too much, she is setting aside her time and that is how she earns her income. She works for you for weeks and weeks, waits for you, shows up whenever you need her, works extra if there are problems without charging more if your birth takes three days or she has to show up three times ready for your birth because you labor made false starts. And you probably don't expect her to charge extra for that either. After everything she does to be ready for you and at your service suddenly losing the income her family needs because you have an extra fast labor or something may be more than she can handle financially if she is going to be able to continue in her work serving women.

Really, those sorts of policies suggest to me that your midwife is both experienced and professional. I would consider it a positive that she addresses challenging subjects like fees which can become messy in an assertive way ahead of time.
 
#5 ·
1. It's common here. My labor was only an hour so ours didn't make it. I wasn't going to say a word though considering I had 35+ weeks of prenatal care, 24 hour communication by phone and pp visits in the fee. Having her at the actual delivery was just a small part of my care.

2. Mine just asked us to make sure we had quick, filling food on hand.

3. It depends. Some here pro rate it, some charge the full amount,
 
#6 ·
Quote:
Originally Posted by BirthkeepinSister View Post

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.
1) My MW would discuss a reduction if she didn't make it due to her own actions (like if i'd called and she just didn't set off). She still expects to be paid if labour is so fast she never made it (she does EVERYTHING she can to be there though, and generally only misses births when mama has called too late). I think if she was in a car crash we'd need to talk about it, but her back-up would still attend me, so i'd still owe her the global fee (which is for prenatal, birth and postnatal care).

2) are you SURE that is definitely for her? I have an online MW friend who asks for coffee and coke at births and both are for different possible scenarios with mom! My own MW gave me a list of foods for labour, they were NOT for her, though it didn't state such on the paperwork. OTOH I do think it's fairly normal for a MW to let you know if they have special dietary needs - they might be at your home for over 24 hours and they have to be at their sharpest and professional BEST at the END of that time. If you've been in labour 36 hours and she's been with you for many of them wouldn't you want her to have the dark chocolate if it gives her a fast sugar and caffeine hit to sharpen her up for the birth!? I would.

3) yes, that's normal, the global fee is for the responsibility for your care. If she only met you at the labour she would still be the responsible professional there. You missing the first 3 appointments just means she has less time than usual to get to know you as well as is ideal before the birth and less time to assess any underlying medical needs you might have. That doesn't benefit her, midwifery care is not piecemeal work the way obstetric care seems to have become.
 
#7 ·
1) Midwives work hard and their fee is relatively small. Hospital deliveries are way more expensive and usually without the special care. Many midwives spend hours with their clients and take a lot ofe care in their work. My midwives didn't actually deliver my baby because I had to transfer to a hospital but they did spend forty eight hours with me before hand.

2) The dark chocolate may very well be for you because during labor your appetite can go to crap and you may need energy food and dark chocolate, fruit or nuts may sound appetizing to you.. If it is food for her that may be a good thing. My midwife kept leaving to get Starbucks and actually had the gall to bring vietnamese food to my house when I was already having a hard time eating and was getting exhausted. The smell to a laboring woman was attrocious.

3) Fair

Most importantly though, outside of these items is that you feel comfortable with your midwife. I liked mine okay, she lost my respect late in pregnancy and I made the poor decision to stick it out. The fact that we didn't vibe well played a lot into me being in labor forever and ending up in the hospital.
 
#8 ·
Disclaimer: I am not a birth professional but the title of this thread caught my attention.

1. Common, I believe. If you have a crazy fast birth then a midwife might not make it in time by no fault of her own. I am not sure I would feel comfortable with a midwife who didn't have a back up for extenuating situations (illness, another birth, etc).

2. I have heard of this before here at MDC but I think it is more common for midwives to make sure to bring food for themselves.

3. Common since the majority of the work is the birth itself.

That said, if you don't feel 100% about your midwife, consider trying to find a new one. I went with a midwife for my second birth that I didn't feel 100% confident in because she was the most convenient person and I ended up transferring to the hospital. I still wonder if another midwife could have guided me to complete a homebirth.
 
#9 ·
I have seen previous posts about midwives requesting food be prepared for them at births. This strikes me as weird. It's not the parents' job to feed the midwives or doulas. They are getting paid to be there.
 
#10 ·
Quote:
Originally Posted by Katie8681 View Post

I have seen previous posts about midwives requesting food be prepared for them at births. This strikes me as weird. It's not the parents' job to feed the midwives or doulas. They are getting paid to be there.
So do you want your MW to leave when you're labouring to get herself food? Or bring enough food to keep herself energised and awake in your home for a possible 36 hour labour? I don't understand this attitude. When i had my homebirths the midwife was MY GUEST. I.e. *I* was in charge of her presence, it was MY birth. Feeding her was part of that. She had no crazy demands for food, but she certainly had a bacon sandwich after the baby came (as did everyone else in the house at that moment!). Why on earth wouldn't i feed her? Where would she get food if i didn't provide it? If i DON'T provide it am i happy for her to say "rationally i cannot go longer than 6-8 hours without eating and still be able to do my job properly, so if you labour beyond that and don't want to let me leave for a few hours to eat then you'll need to transfer/UC"?

Midwives are HUMAN, humans need to eat!
 
#11 ·
Quote:
Originally Posted by GoBecGo View Post

So do you want your MW to leave when you're labouring to get herself food? Or bring enough food to keep herself energised and awake in your home for a possible 36 hour labour? I don't understand this attitude. When i had my homebirths the midwife was MY GUEST. I.e. *I* was in charge of her presence, it was MY birth. Feeding her was part of that.
So you didn't pay your midwife? She was your guest? In my house, I don't pay people to be guests/friends. I pay professionals to do a service. I would not put myself out to feed my midwife- I would expect her to bring her own food. Hell, at 39 weeks, I was barely shopping and cooking for myself! This is the time in life when people help YOU out.
 
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#12 ·
I've been to births where I tried to bring food for myself and the parents didn't have a working can opener I could use to get my ravioli open. I did end up having to leave, get food at a drive-thru and come back.

I think it's pretty basic to provide food for someone who's going to be stuck at your house.
 
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#13 ·
I think it is nice to provide food if you can, but I would not expect to get a list from the midwife about what she wants... Are you sure it was for her? My midwife gave out a list of foods to have on hand for myself during labor, but never expected me to provide her with meals. She has also left during early labor to go get food and give me some space, no big deal for me.
 
#14 ·
I went through the same thing, though for completely different reasons, with my first midwife. I would say it's not the requests themselves, but just that something about her isn't setting right with you in general, and her requests and lists are a tangible thing for you to look at when you say, "See, there really are some problems!" (I did the same thing at first because it made me feel like less of a crazy preggo lady, but ultimately, it was more than just the tangibles. My first MW and I really just Did. Not. Work.)

Don't sell your inner voice short. It's probably not the chocolate that's the issue, but something you're not yet able to articulate about her, her practice, her demeanor - whatever it is. You only birth this kiddo one time, so if you're not 100% on the MW you have now, take a hard look at dumping her. Do a little soul-searching first, make lists, do some pro/cons, talk to your partner, family, squirrels in the trees - whatever it takes to help you feel that your decision is justified - but really, if there's something that's just wonky, end the relationship sooner rather than later, for both your sakes. The last thing you OR she wants is for the relationship to become adversarial, unproductive, toxic, etc, just as you go into labor.

FWIW, some midwives will prorate their fees if you come to them part-way through your pregnancy. My new MW did. You just have to ask around, and not be afraid to say "This is what I have to spend, due to my initial outlay with MW #1. What service will this allow you to provide/me to receive?" If your new MW can't make that dollar amount work, they'll let you know. And be prepared for your new MW to ask what made you uncomfortable, or what made you switch. It's not personal, it's so you two don't make the same mistakes in your interactions with each other. Your new MW probably won't expect you to have specifics, but will likely want to know under what situations those feelings happened. For mine, it was interactions with her doula, and the way she touched me/interpreted touch, but what I initially said was more like, "Too damn handsy!" I blame the hormones.
 
#15 ·
Quote:
Originally Posted by Katie8681 View Post

So you didn't pay your midwife? She was your guest? In my house, I don't pay people to be guests/friends. I pay professionals to do a service. I would not put myself out to feed my midwife- I would expect her to bring her own food. Hell, at 39 weeks, I was barely shopping and cooking for myself! This is the time in life when people help YOU out.
Actually i'm in the UK, so no, i didn't pay for my first homebirth, it was NHS. Those midwives had 2 cups of tea and some Birth Day cake. I had never met one of them. They were very professional, fairly cool in their manner, didn't know me and thus thought i was not in labour and merely very dramatic about pain until my DD's head began to emerge. I wish i'd had the chance to have some tea and food with them at some point before, i wish they'd known me, even just a little.

My second i paid for, with an independent midwife. She had hour long or more (mutually agreeable) appointments in my home, you can bet i made her a cup of tea or coffee and offered her a biscuit when she was spending so long here, and because it's NICE to share a drink and a chat! At 39 weeks with #2 i had a family to shop and cook for and feed and i did so, in labour i had OH or my dad around, they did any cooking (it was only after the birth anyway, i sure wasn't doing it then!). That MW and i became very good friends once she'd discharged me at 1month PP (i mean, we were friends before, but i too felt that being "off contract" would make it a friendship and not a friendly professional arrangement), we have lunch together every week still (and i don't have to pay her!). That was what i wanted, perhaps not a lifelong friend (who could expect that!?) but someone who i genuinely felt good about being around. If i'd wanted a "professional" to come in, do their job and go away i could have had an NHS homebirth again. My DD's birth was intimate, cheerful, beautiful, because the energy in the room was that of caring and friendship. By spending so much time with me she knew me really well, well enough to give me completely tailored care. That is what i was paying for. Someone who knows about "vaginas" and "dilation" can be gotten for free in this country at most hospitals - they will save your baby if need be but they will NOT save the birth experience for you or your infant. My MW could offer both, the medical knowledge she has studies and practised hard for, and the intimacy borne of her sustained efforts to get to know us all. When you have a baby you need a lot of support, when you support someone having a baby you need some support too. We often talk about "mothering the mother" - the people who do that need to be supported too, in the scheme of the caring support she gave me over the 7 months i was in her care, the bacon sandwich (which i didn't even have to make!) pales immediately to insignificance.
 
#16 ·
Quote:
Originally Posted by SquidMommy View Post

I would say it's not the requests themselves, but just that something about her isn't setting right with you in general, and her requests and lists are a tangible thing for you to look at
I agree with this.

I also thought it was fairly common for women birthing in hospital to sometimes bring treats for the nurses?
 
#18 ·
Quote:
Originally Posted by slmommy View Post

I agree with this.

I also thought it was fairly common for women birthing in hospital to sometimes bring treats for the nurses?
This happens sometimes (rarely), and it's a pleasant surprise, but definitely not an expectation. I cringe when I see recommendations that you bring treats for the nurses to get them to treat you nicely, or something. When you get information prenatally from the hospital, they don't tell you to bring food for the staff. Nurses, CNMs, and docs are not going to make it your problem that they didn't plan ahead for meals during their shift. And yes, if it's overnight or, in many hospitals, over the weekend, we do have to bring our food in; cafeterias and restaurants close. It's just part of the work.
 
#19 ·
Quote:
Originally Posted by Katie8681

This happens sometimes (rarely), and it's a pleasant surprise, but definitely not an expectation. I cringe when I see recommendations that you bring treats for the nurses to get them to treat you nicely, or something. When you get information prenatally from the hospital, they don't tell you to bring food for the staff. Nurses, CNMs, and docs are not going to make it your problem that they didn't plan ahead for meals during their shift. And yes, if it's overnight or, in many hospitals, over the weekend, we do have to bring our food in; cafeterias and restaurants close. It's just part of the work.
Yeah, I realize it is not a requirement... If I ever had a hospital birth, I would be bringing chocolate, no problems sucking up here. I realize you don't have to do that to be treated nicely, but anyone who has ever worked a service industry knows it sure as heck doesn't hurt. Having food available for someone stuck in your house for possibly many, many hours, attending to you, doesn't sound ridiculous.

OP, did you ask her? pps have suggested maybe mw wanted those things on hand for you. It sounds like most of them you can purchase in advance and are things that will keep if not eaten... cheese and crackers, dried fruits and nuts, chocolate. Who knows, maybe she's had bad experiences before in this department somehow. Maybe moms in the past have freaked out and stressed about making her meals/food from scratch, maybe she had a bad experience when she had to leave to get food, who knows.

ETA: I just brought up the bringing nurses treats thing because after reading GoBecGo's post, I started thinking about all the ways people connect over food and sharing food.
 
#20 ·
If I have a homebirth next time I will probably have a lasagna defrosting when I start labour for anybody around to eat. Anybody who wants fancy food can fetch it themselves, end of story. If her list of foods is in fact for her, not you, I would ne really turned off. The last thing a pregnant woman, much less a woman in labour, needs to worry about is having a special foodlist on hand. Nope! Casserole or bust.
 
#21 ·
those honestly sound like food for the mom and dad, but something to talk to her about. The midwifes I had for my last birth asked that there was food in the house for everyone attending, including them, and specified that they were vegetarians. I ended up just having some vegetarian frozen meals in my freezer that they ended up not eating, but I ate afterword. for them it was to make sure no one was having a blood-sugar crash toward the end of a long labor if they ended up going to back-to-back births or didn't get the chance to pack something.
 
#22 ·
Quote:
Originally Posted by Katie8681 View Post

And yes, if it's overnight or, in many hospitals, over the weekend, we do have to bring our food in; cafeterias and restaurants close. It's just part of the work.
Yes, but you know when you're going to be working, and there's no emergency that requires you to get there RIGHT AWAY, without possibly even the chance to pack a meal or pick one up on the way. Not the same thing.
 
#23 ·
Quote:
Originally Posted by slmommy View Post

I also thought it was fairly common for women birthing in hospital to sometimes bring treats for the nurses?
I've never heard of this. It is hard enough to bring all the stuff the laboring MOM needs! When you are in labor is one of the few times in your life that you really don't have to think of what might be pleasant/ideal/extra special for other people... When you come back for your six week check up, you could bring a thank you treat for nurses that were great to you, but I can't imagine packing treats in for them during labor!

My homebirth midwives didn't ask for a thing. They were welcome to bring whatever they like to eat for lunch/dinner/etc (as any of us would to a job where we don't have the option to leave the premises) or to share ours as we adore them - but to be given a list of specifics? That would bug me too. I don't get a list from anyone else who provides me a service - though I'd certainly offer the guys from the moving company or the teen who mows my lawn a cold drink. Babysitters or pet/house sitters are welcome to anything in the fridge/pantry but I'd find it odd if they sent me a specific "have this on hand for me" list.
 
#24 ·
1) I think so. My midwife does this specifically so if a baby comes before she can get there (long drive, at another birth, whatever) that there's no incentive for the parents to say "oh no, don't come, we're fine." Immediate postpartum check ups are important, and apparently there was a death by hemorrhage in my area due to this.

2) Yes, feeding midwives and moms is good. I didn't have any specific requests, but the midwives and doula wound up eating most of the leftovers in our fridge after my birth. We of course had no problem with this.

3) It depends. If they have a global fee keep in mind they're not charging you extra if you go overdue.
 
#25 ·
Quote:
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?
It depends on the reason. If they don't make it to the birth because they're at another one, they missed the phone call, or something of that sort, then a partial refund would be due. I would expect them to have a contingency plan in place (a back-up MW they would call) if they have 2 births at the same time though. If they don't make it to the birth because you didn't call early enough, or because your birth was precipitous (something out of their control), then yes, they would still expect full payment.

Quote:
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!
Like pps have said, I would clarify this with her. My MW did include a suggestion list of foods to have on hand. They are suggestions, and they are intended mostly for *us*, not for her. But, having something on hand for everyone to eat is a smart idea.

Quote:
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.
Yes. That is standard. There might be a few MWs who would be willing to negotiate it with you, but most do not break down their fees that way. The bulk of the time a MW spends with a mama is in the labor and pp period, not during prenatals.

But I agree with the pps - your gut reaction to these things likely has nothing to do with these specific questions. Follow your gut, and if the relationship isn't sitting right, whether you can come up with a logical reason or not, find another MW. I interviewed 8 MWs this pregnancy, 8 MWs last pregnancy and 3 MWs my first pg to find someone who felt right for those circumstances.
 
#26 ·
Quote:
Originally Posted by Turquesa View Post

I am gearing up for my third out-of-hospital birth, and I have never heard of a client's obligation to feed midwives. At the risk of getting flamed, I actually think it's pretty tacky for midwives to require that. Every other professional I can think of---even those working unconventional hours in unconventional locations--has a responsibility to make their own provisions for food.

I've had contractors at my home working long, extended hours. They bring their own lunches/dinners or take breaks to eat out. Bank employees are stuck at the bank all day, and doctors are stuck in hospitals and clinics for the duration of their shifts. They're all human, they all need to eat. But it's rather audacious to require that their own clients--the very people paying them for their goods and services!--provide that food for them.

I have no problem with clients voluntarily providing nibbles to professionals that they appreciate, but it shouldn't be expected of them. Laboring women, especially, shouldn't feel like they need to go to those heroic, people-pleasing measures. I understand that some women find it helpful to bake cookies and the like to keep their minds off of labor. I think that's great, and it's great that they share them. But....wow. I hope the OP got some clarification of the midwife's expectations. OP, if the food is indeed for her, I wouldn't be comfortable, either.
I agree. Especially things like dried fruit, nuts and chocolate which are pretty easy to keep as part of your kit since they tend to have a pretty long shelf life.

OP, have you been able to clarify with her whether the food is for her or you?

ETA - oh and on the subject of food gifts for hospital staff. It is not unheard of here although I wouldn't say it happened frequently but it is *always* given at the end of the person's stay not at the beginning so there is no question of " getting better service".
 
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