[mattjule]

My first mw had a birth attendant that was sort of an apprentice but mostly just a birth attendant. My mw this time utilizes mw collegues as birth attendants. She says she feels more comfortable that they have the same degree of training she has. How many of you midwives feel the same way?

I am wondering b/c I love the homebirth field, but with small children I really don't want the investment/responsibility of being a mw. Plus there are a lot of mw's in my area already. Being a birth assistant is much more what I would love to do, at least while my children are still little. How do I find training? Is this even possible? Would I face the same bias my mw has professed?

 

[dynamicdoula]

It sounds to me like you're most interested in labor doula work. There are three types of doulas:

*antepartum doulas attend women who are on bedrest or experiencing high risk pregnancy, to help around the house, help with other children, etc.
*labor doulas support women who are in labor by providing informational, physical and emotional support (but nothing medical)
*postpartum doulas support women who have just given birth by running errands, light housework, sibling care, and newborn care, breastfeeding support, etc.

I am the CAPPA Northwest Regional Rep, CAPPA is the only org that trains antepartum doulas, but there are a couple of others who also train labor/postpartum doulas. Check out these sites to get information on trainings in your area!

www.cappa.net
www.dona.org
www.alace.org

 

[birthinglau]

Julie,

yes, there is such a thing as a hb midwife's attendant. the Farm (homebase of Ina May Gaskin, of Spiritual Midwifery fame) midwives offer a midwife assistant's training, which I took in May and June of 2002.

I have found that the idea is not as widely known as apprenticeship (even among midwives) but the ladies at the Farm have utilized assistants themselves, and believe it's a good step up for women interested in persuing midwifery, but who maybe aren't sure they want to become a midwife, or can't make the committment yet due to family reasons.

I learned anatomy and physiology of mother, fetus and newborn, palpation and ausculation, neonatal resuscitation, charting, use of O2, universal precautions and so on. everything I need to know to assist at a birth, attend prenatals and postpartum visits, but without the responsibility and additional experience of a midwife.

perhaps your midwife has such a good relationship with the fellow midwives that she sees no need to add another person into her way of practice. or perhaps she had a bad experience with a flaky apprentice/assistant? or maybe she doesn't have a concept of exactly how an assistant would work?

I am not active at the moment, being unexpectedly single with a 14 mo. old. but I have another aspiring midwife friend who is assisting a midwife at present, and like you and I, she loves midwifery, and wants to be involved, but can't be a primary health care provider and maintain her responsibilities to her family (she's a single mom of 3 year old and 5 year old).

-Lau

 

[doulanichole]

This is something I am interested in as well. I am a certified labor doula with DONA and am very interested in homebirth. I attended one homebirth while pregnant and then had my last baby at home. The mw's in our area also use apprentices as assistants and I think some of that may have to do with the fact that the apprentice is not being paid. Are you willing to be a birth assistant for free or were you looking for compensation? I would love to know how others are doing it and if midwives assistants are being paid in other areas of the country. This is something I would love to do and certainly wouldn't be expected to be compensated the same as I would for a hospital birth, but would expect something for my time, etc. Thoughts?

 

[mattjule]

Everyone I know of does pay their assistants. My first mw, who had an assistant/apprentice, paid her. I know for sure b/c I had to pay on top of what my insurance paid since they didn't cover the assistant. I just assumed this is regular practice, maybe it's not?

 

[pamamidwife]

I love using my apprentice as my assistant, and if I was approached by someone like her that just wanted to assist without the intention of becoming a mw, I'd definitely take them on! What a gift!

(My apprentice kicks all kinds of butt, though....and it will be a very hard day when she leaves my practice)

I pay my assistants - even when they're apprentices. I work it into my regular fee and I also bill insurance for it.

 

[birthinglau]

I would expect to be paid, as it is a service that I would be providing to the family and the midwife.

doulanichole - I am curious why you would charge less for a homebirth assisting than for doulaing a hospital birth? my own thoughts are that I should be paid about the same, since my job is potentially really important, though different than my job in the hospital as a doula. what if I had to help catch if the midwife couldn't make it?

-Lau

 

[doulanichole]

Interesting that apprentices are being paid in other parts of the country. The climate here is a little different anyone who wants a homebirth must pay out-of-pocket as insurance will not cover it. That's one of the reasons I would not charge as much as I would in a hospital. Coming out-of-pocket for a midwife is difficult enough ($2000), but adding a doula on top of that ($500 - what most charge) makes it almost impossible for women to have both and they feel as if they have to choose. For me personally, it would have cost about $250 for me to have a hospital birth, but i was willing to pay the $2000 for the homebirth. If I didn't have doula friends willing to attend my birth for a small gift, I would not have had both.

Although I do see my role as being different at home than in the hospital, I see it as being far more difficult in the hospital and in preparation for a hospital birth. A lot of the preparing you have to do in prenatals for hospital births would be non-issues in homebirths so for me that would affect the cost. Of course I realize that this is not true in all cases, but I would be happy to charge less if I knew I would always be working with a competent midwife in a homebirth situation. I would love to know how other mw's pay their assistants - is it a flat fee per birth, a percentage or what? There are a couple of us here that would welcome the opportunity to make the transition, but don't have a plan for compensation. Like I said, it's hard to get in there when there are others willing to work for free. Any thoughts?