Fortunately, I have never had a problem with a client, but I do take the
following precautions:

First, I ask who referred them.  This is helpful both in realizing where
I am getting business from, as well as validating the client a little.

I have caller ID, and compare the name and number the caller gives me
with the one that shows on the phone.  If they are different, I will
note the discrepancies in my phone log.  (Usually the mom will
spontaneously explain she is staying with her parents, living with her
in laws, etc.)

If the baby's father or grandparent calls, I congratulate them and then
ask to speak to the mother.

I speak to the mother a little while before making any committment to
see her.  Mostly it's to screen her and make sure she really needs help
(they usually do, but some are worried about normal things, like baby
wanting to feed more often than someone told them he should) but it also
gives me an opportunity to feel her out.

I then call back to confirm the appointment, either the next day, or
when I am on my way (this confirms the telephone number).  I also leave
my appointment book at home, with everyone's name and address and phone
number in it and the time I was due there.  This way my family knows
where I was.  Each morning, I share my plans for the day with my
husband.  I also occasionally check in with him by phone, to let him
know where I am and when I plan to be home.  If something comes up at
the last minute, I give him a quick call at work and tell him I am
making a home visit, and where.

If you know your neighborhoods well, you can also judge how safe the
area is where the mom lives, and encourage her to come to your office,
or bring an intern or colleague if it is not one you feel comfortable in
alone. I have been in some interesting areas, in half finished houses,
in homeless shelters in really poor neighborhoods, but have not had any
dangerous situations, thank God.  I do believe in following my
instincts, and if someone were really off the wall or not genuine, I
like to believe I would notice and take heed.

I don't worry a lot about danger, but I do know that it is out there and
try to take precautions.  Maybe I'm just a paranoid New Yorker!
--
Catherine Watson Genna, IBCLC  New York City  mailto:[log in to unmask]

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