How to Choose a Midwife

Midwife Home Visit

Midwife Home Visit

It has been a few years since Joy posted about her experience giving birth with a midwife. She wrote a series of three great posts: Choosing a Midwife, The Unique Perspective Midwives Bring to Birth and Top Ten Reasons for Choosing a Midwife Over an MD. I recommend them to anyone even considering going with a midwife, not just for a home birth but at a birthing center or hospital.

When I was pregnant with Frances, the only maternity insurance a self-employed woman could get in our state only covered emergencies. After doing a little research, I discovered a hospital birth would cost us at minimum $10,000 out of pocket. Since birthing centers are illegal here, we decided to look into a home birth with a midwife. I never thought I’d give birth at home, but I’m too frugal to drop $10K when there are cheaper alternatives. Plus, I had the assurance that if complications arose, we were covered by our insurance.

Now that Obamacare has mandated I have access to maternity coverage, I could give birth at a hospital without going bankrupt. The thing is, I wouldn’t dream of it! I had such a wonderful experience with a midwife-assisted home birth, I’m excited to do it again.

Since there are no birthing centers in our state, and no state licensing for midwives, we had to be extra diligent when choosing a midwife. It was up to us to make sure she was experienced and qualified.  To make sure we were thorough, I scoured the internet for advice on what to ask a potential midwife. I consulted many websites, and came up with a list of questions that elicited comments like, “Wow, you’re prepared!”, and “What a thorough list of questions.” from the midwives we interviewed.

With a few exceptions, these questions aren’t just good for midwives. It wouldn’t be a bad idea to interview a few OB’s with these questions before committing to one.

Questions for Midwives

  1. How many births have you attended? How many births are you attending now?
  2. Do you participate in regular peer review?
  3. Do you maintain statistics from your births and what happens at each one?
  4. Have you ever been named in a law suit? Please explain.
  5. Have you had any bad outcomes for the baby or mother? Please explain.
  6. Have you had any women dissatisfied with their care? How did you handle this?
  7. How many hours of continuing education do you complete each year?
  8. What if you are unavailable, for some reason, when I go into labor?
  9. Which doulas have you worked with? Who would you recommend?
  10. Is water birth an option?
  11. Do you have a doctor you work with if it’s deemed I’m high risk at any time?
  12. Who are your usual assistants and when can I meet them?
  13. What conditions would cause me to be “high risk”? How would you treat these conditions before they make me “high risk”?
  14. What is your hospital transfer rate?
  15. What is the protocol for a hospital transfer? How do you decide if it’s needed and how would it be done?
  16. Would you remain with me if I end up being transferred?
  17. What happens with your fee if I have to transfer out of your care?
  18. What is your cesarean rate?
  19. Do you monitor and check the baby’s heartbeat during pregnancy and labor?
  20. Are you certified in Neonatal Resuscitation? CPR? Advanced Life Support in Obstetrics? Pediatric Advanced Life Support?
  21. Have you ever had to resuscitate a baby?
  22. Do you have a protocol to help prevent me from being positive for Strep B?
  23. Are you willing to use alternative protocols for Strep B positive?
  24. Have you had experience with shoulder dystocia? Breech babies? Cord prolapse?
  25. Do you have experience turning a breech baby?
  26. What happens if the baby is in distress after it’s born?
  27. When do you decide to transfer the baby and how?
  28. Do you have a pediatrician you work with or recommend?
  29. Under what conditions would you artificially rupture the membranes?
  30. At what point would you consider the artificial induction of labor? What are some of the methods you use?
  31. What happens if I go past 42 weeks?
  32. Do you do pregnancy and newborn screening blood tests or will I need to see a doctor for this?
  33. What equipment do you normally bring to the birth?
  34. What is your opinion about eating and drinking during labor?
  35. What is your episiotomy rate? How do you work to prevent tearing?
  36. How many third or fourth degree tears have you had?
  37. Can you suture if a tear occurs? Up to what degree?
  38. Do you have a problem waiting for a while after the placenta is delivered to cut the cord?
  39. What do you use to stop excessive bleeding after delivery?

Did I forget any questions? Please add to the list!

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