Grade Me Too

When a new client tells me who their provider is, I do some homework.

I ask around. Other birth workers, nurses, parents who've been there. What does this person do well? Where do families tend to need a little extra support? Then I bring it back to my client, so we know where to focus our prep.

I was writing one of those summaries last week, and a thought snuck in.

What would people say about me?

So I asked. Fair's fair.

What came back

Clients say I'm candid. I tend to say it how it is.

They mention prenatal visits where we walk through every option. Hands-on comfort that finds where the pain is sitting. Working out a Spinning Babies technique together with a midwife after a cervical check. Making sure an eight-year-old big brother got called in when the baby was coming. Draining the birth tub and hauling it outside afterward. A debrief one client later realized she really needed.

Lovely to read. Also, people who leave reviews are usually the happy ones. So I kept going.

Where I'd poke, if I were interviewing me

I'm candid. The thing one client loved could feel like a lot to someone who wants a softer, quieter presence. That's a real fit question, and a consult is a much better place to find out than labor.

I wear a lot of hats. I run a training program, host weekly mentoring calls, and have a lactation educator course on the way. A family has every right to ask what my on-call window looks like, and who my backup is.

I come in with an advocacy lens.  I research providers. I prep clients to ask hard questions. Plenty of families want that. Others would rather follow their provider's lead, without a lot of background info or anything that gives them a reason to second-guess their choice. That's a valid way to give birth, too, and it deserves a birth worker who fits it.

Any one of those could make me a mismatch for a particular family.

Nobody has to be the villain for a different fit to make sense, me included.

The point is an honest look at fit. Knowing it early saves your client, and you, a lot of time and aggravation.

Providers get the same honest look. A surgeon with a high cesarean rate can be exactly the right choice for a family planning a cesarean. Skilled, efficient, great in the OR. For a family hoping for a vaginal birth, that same quality is a good reason to ask more questions. Same provider, different fit.

Your turn: grade yourself

Families are going to ask you these questions, or quietly wonder about them. Answer them for yourself first. If one makes you squirm a little, that's useful information.

Availability and backup

• Can I clearly explain when my on-call window starts and ends?

• How many families can I realistically take around one due date?

• Who's my backup, and have my clients met them?

• What's my plan if I'm sick, or at another birth when a client goes into labor?

• Am I vaccinated? What do I do if I've been around someone contagious?

How I work

• How do I support a client who makes a choice I wouldn't make?

• How do I really feel about epidurals, or any other intervention a client might want? Does it show?

• How do I include partners, family, and other support people?

• How do I make sure a client's culture, family structure, identity, and language are respected?

• What does consent look like with me, for touch, photos, or video?

• When a client asks what I really think, how honest am I? And how kind?

Bias and beliefs

Can I fully support someone whose beliefs or choices are very different from mine? Someone who:

• Wants a lotus birth

• Is unvaccinated and against vaccines

• Wants every intervention available, and would rather not feel birth at all

• Is planning an unassisted birth (birth worker liability insurance generally won't cover attending one, so the real question is whether I can support them prenatally and postpartum without judgment, and explain that boundary kindly)

• Practices a faith different from mine, whether that's Muslim, Wiccan, Orthodox Jewish, evangelical Christian, or no faith at all

• Votes very differently than I do

• Is a teen parent, or a parent much older than I'd expect

• Is using substances during pregnancy

• Is placing their baby for adoption, or carrying a baby for someone else

• Plans to formula feed from day one

• Has a family structure that's new to me

A pause on any of these is honest information. Sit with it, learn where you can, and refer on when you need to.

Working with providers

• Do I know the providers and birth places my clients are choosing?

• Do I help clients speak up for themselves, or do I end up speaking for them?

• Can I clearly explain where my role stops and the provider's begins?

Fees and after the birth

• Can I explain exactly what my fee includes, and what it doesn't?

• What's my policy if I miss a birth, or a client's plans change?

• What does my postpartum follow-up look like? Do I offer a debrief?

Then the gut-check part. When a family leaves a consult with you, do they feel heard? Held and honored, or judged?

Check your own gut, too. Sometimes an interview just feels off, and you can't put your finger on why. That's the time to listen to your intuition and refer them on. You don't need a reason you can explain for it to be the right call, for them and for you.

Open to feedback, open to change

We ask a lot of families. Tell us your fears. Hear things you didn't want to hear. Change the plan when the plan stops working.

That goes both ways.

We all have to do our best work and be our best selves in that room. Part of that is asking for feedback, listening when it stings a little, and actually changing when it's warranted. A debrief is for us, too. So is the review that makes us wince.

Try it this week. Write down what your clients would say you do well. Then go back through those questions and write down where you'd poke, if you were interviewing you. Be honest. (Kind, but honest.)

We're talking about this one at Monday night mentoring, along with the changing-providers post. Bring both lists. You've already seen mine.