Personally, it took a lot of time on the path of martyrdom for me to really get clear about how that self-sacrifice thing does not serve anyone. I have done many births in my career for free because I “felt sorry” for the couple. This is a kind of arrogance about others that usually ends in disaster. Now it seems particularly ridiculous that I did a lot of this free work when I was a struggling single parent with two little kids who I could barely feed. What was I thinking? I would burn out my friends with unreasonable requests for babysitting, let my pantry get bare, be exhausted and cranky with my children and still not collect money from the clients because they were “so poor.” Learning to see others as whole, complete, capable adults took a long time.
When we charge a fair fee for service, as other workers do, we leave the relationship with the client whole and complete. I remember doing a birth for a couple for a ridiculously low fee because I was told “He is a seasonal worker and they really want to have a birth in their own home.” About three months after the birth, the family phoned to tell me they were going on a trip to Disneyland. I was very resentful and did not want them to have a nice holiday when I had gone into debt to be at their birth. Lesson learned. Now I’m thrilled when my clients tell me they are buying nice things because they owe me nothing.
Even if people have a tough time with finances, there are still things they can sell if they want the service you offer. There are enough pop bottles on the street to generate the money for a midwife or doula. There are grandparents who would love to pay for a midwife/doula service for the new grandchild. There is a way to pay $50 per month for a year if one really wants birth services.
I love this quote from Dr. Kloosterman of Holland, who is an obstetrician and a great friend to the natural birth movement:
“All over the world there exists in every society a small group of women who feel themselves strongly attracted to give care to other women during pregnancy and childbirth. Failure to make use of this group of highly motivated people is regrettable and a sin against the principle of subsidiarity.” (Note: The principle of subsidiarity is that nothing should be done by a larger and more complex organization than can be done as well [or better] by a smaller and simpler organization.)
It’s important to note that Dr. Kloosterman doesn’t say “give care for free or for a ridiculously low return.” “Make use of this group” does not mean “make this group into martyrs.” I have seen so many good women come and go from the birth movement who do not have a balance between what they give and what they receive. It simply doesn’t work to be dishonest about our own needs and the needs of our families when we go to births.
First published as “Midwifery Tip from Gloria Lemay,” The Birthkit, Issue 36 and available online on the Midwifery Today E News
Oh, how right you are! It took me years to work up the courage to ask for a fee for my services. I think women as a whole and midwives in particular tend to devalue their services and skills. I still tend to offer a reduced fee to those who really are in dire straights but probably shouldn’t.
Been there for the sob story and subsequent purchases too.
Its a bit hard for the rest of the world to value midwifery care if we dont ask for what we are worth.
I agree that we dont do anyone any justice by undervaluing our services, in fact it supports the view that midwifery care is ‘not as good/professional’ (whatever that means) as the care you would receive from any other health care provider.
I pay more per hour for a massage therapist, a plumber, vet care for my pets, and going to the chiropractor than I am paid if I work at the local hospital.
And yes I too have undercharged out of compassion (yes me too the single parent with 2 kids), only to see my poor clients buy the new car or have the kitchen reno some months later.
Undercharging is a false economy on so many levels.
You are so right on with this Gloria. I firmly believe that the worker is worthy of her wages, yet some still link money with un-spirtuality. I no longer buy into those false beliefs. It is not un-spiritual to be successful and profitable in your chosen profession- whatever it is. I don’t give away my services anymore. Do I have less work as a result? Yes, but I’m far happier with the jobs I take.
Thank-you. This is something I’ve been struggling with 🙂
You are so right… Women should never “put themselves on sale,” says a famous female financial adviser, Suzie Orman. I have given clients a much lower price when I had a sliding scale (based upon qualifying for a medical card or other government programs, and income per capita), and still not pay the payments, requiring me to pay my assisting midwives out of pocket for them… never again… I have been so tight I did not have gas money, and then had clients seem put out when I asked for payment when they were months behind the birth… live and learn, and be clear about valuing yourself as you value and serve women.
Do you notice that tire salesman and gas stations don’t have sliding scales? Whenever I’m offered a sliding scale, I slide right down to the bottom end. No sliding scales for anyone. We are working with adults who are going to be buying food, rent and schooling for a child. The sooner they get on with earning money the better.
I attended a birth many years ago. Second baby for this couple. Lovely birth, woman soaked in the tub at home then I drove them to the Hospital. Birth was quick, short pushing stage . On the postpartum visit the woman says to me ” my birth was so short, we don’t feel that we should pay you the full fee. ” I looked her straight in the eyes and replied ‘ I don’t charge extra when the birth is 36 hours, you were blessed with a glorious short birth . “
I think the overarching issue is about boundaries and doing what is right for you. Money is very important issue but imo the relationship one has to money in one’s life operates under the rubric of boundary setting. To me it is not a problem to use a sliding scale, the problem is using a sliding scale and not being comfortable with it. it’s about having clear boundaries.
I see nothing wrong with people offering their work free of charge if that is what they choose to do equally as I see nothing wrong with Gloria charging a non-negotiable fee for what she does. Gloria charges a fee for a service, people
I think it becomes harder to stomach fees like 500$/hr lawyer fees, or banking fees, or real estate agent fees, or airport upgrade fees…etc as those to me are fees based on exploitation, disempowerment and greed.
Only the person charging the fee knows if they are being greedy or if they are charging a fair price. There is nothing wrong with making money, which I know for women is sometimes a difficult concept to internalise as often our work is unpaid, undervalued and ignored and so we might confuse our desire to make money as being greedy when in fact, it is what Gloria states, unreasonable self-sacrifice that generates resentment.
But again to reaffirm to me the issue is about boundaries and taking responsibility by setting them and clearly communicating them. And boundary setting around money tends to be very difficult for people in the business of offering health and wellness services.
All of this is so, so true. My biggest pet peeve is when other doulas, so obsessed with competiton, will under-cut a fee (mine or someone else’s) just to get business. They don’t realize they devalue all of us when they do that, themselves included.
After 7 interviews we finally found our doula and she turned out to charge significantly more than we had budgeted for. So we had a garage sale and raised enough money so that we didn’t blow our budget and paid her what she asked. She was worth every penny. Without her, my home birth would have been a c section.
We disrespect people by not treating them as responsible adults that can make good decisions. This includes money. It took me a year each to pay for my midwife years ago. I was not ashamed and she was happy that I paid monthly.
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Thank you for this! This is an issue I have been struggling with for many years as a nanny and I have only just recently gained the confidence as a postpartum doula to say “hey, I know something, and my time, knowledge, and genuine passion for this deserve to be paid accordingly”. When we allow others to treat this profession as a sort of “hobby” or simply an act of good will, that’s all they will ever value it as. As doulas, midwives and other holistic practitioners we have chosen this as an actual career. Yes we have hearts and sympathize with others financial needs but just as we preach to our clients that a mother cannot properly serve her family if she doesn’t put herself first, we cannot properly serve our clients if we are not meeting our own needs first either. I totally agree that if some one truly values what you do, they will make it work…. “Where there’s a will there’s a way”. Don’t sell yourself short, ladies!
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