Choosing a midwife is not always easy – there are so many things to consider! Do you agree with her philosophy about birth? Do you feel confident in her training, experience and skills? Is she someone you feel comfortable partnering with to provide care during your pregnancy and trust to help you during your birth? Do your personalities “mesh” and do you feel at ease with her?
I always suggest clients interview other midwives if they don’t feel that all these things line up for them. It’s an important decision, and the midwife you pick should feel just right for you – the midwife/client relationship isn’t “one size fits all”. The midwife you pick will accompany you through the journey of pregnancy, birth and postpartum. Think of the midwife/client relationship in terms of friends and road trips: you might get along fine with many people who would you pick to drive cross country with?
Here are some questions to get started with when interviewing midwives:
1. What is your general philosophy about pregnancy and birth?
2. What is your education and training as a midwife?
3. Are you licensed by the state?
4. Are you a member of your state midwives’ association?
5. How many years have you been practicing?
6. How many births have you attended? Please differentiate between births where you’ve assisted and those where you’ve been the primary midwife (responsible for labor management, the birth, newborn exam, postpartum care).
7. Are you a mother yourself? How old are your children now?
8. What were your own birth experiences like. Have you had a home birth yourself?
9. Do you participate in a peer review with other midwives? How often?
10. What is a typical prenatal visit with you like, and how long do visits last?
11. Do you routinely perform vaginal exams? When do you think they’re indicated and why?
12. What happens if I go past 42 weeks?
13. What do you do if you discover a baby is breech?
14. Do you require clients to complete a childbirth education class? Do you teach childbirth education, or can do you refer clients to a particular educator?
15. What do you do if I develop a condition that makes me “high risk”, and what are the conditions that would “risk me out” of midwifery care?
16. Do you have an affiliation with a physician who can answer questions about unusual developments either during the pregnancy or in an emergency?
17. Do I need to see a physician during my pregnancy even if I don’t have any complications?
18. How many births do you attend in one month? Do you limit the number of due dates in any 30-day period too avoid conflicts?
19. Who else would be at my birth? Another midwife? A birth assistant? What is her experience and training? Will I meet her before the birth?
20. How do I reach you when I’m in labor ?
21. At what point in my labor will you come to my home?
22. What kind of labor support do you provide?
23. Who can be with me during my birth? Is it ok for children to be present?
24. Can my partner “catch” the baby?
25. How often do you check the baby’s heart rate during labor? How do you do this? Do you use a fetoscope or a doppler?
26. Do you have any experience with shoulder dystocia? Postpartum hemorrhage? Cord prolapse?
27. If my water breaks before my labor starts, what do you recommend to help labor start and how long do I have before it’s necessary to transfer to the hospital?
28. What is your back-up situation? What happens if you can’t make it to a birth because of illness or emergency? Will I meet the midwife who would be your backup?
29. What do you do if another client is in labor at the same time I am?
30. Do you do anything to help prevent tears, and what kind of tears are you able to repair?
31. Under what circumstances would you perform an episiotomy, and how many times have you done this?
32. Have you ever had a client complain about your services? Could you please explain the circumstances and how you resolved their complaint?
33. How do you handle emergencies? Under what circumstances would you transfer to a hospital?
34. Will you come with me if I have to go to the hospital, and how long would you stay with me?
35. What is your transfer rate, and what are the reasons for transfer? How many women whom you have attended have had to go to the hospital?
36. What hospitals do you transfer to?
37. Do you keep statistics for birth outcomes? Do you participate in the MANA statistics project?
38. Have you had any bad outcomes with mother or baby? Please explain.
39. How do you handle emergencies or complications that develop during labor. Could you describe a particular emergency situation and how you handled it?
40. What kind of equipment and medications do you bring to a birth?
41. Do you perform the newborn screening test (PKU) or do I need to take my baby to a pediatrician for this?
42. What are your fees and what do they include (and what don’t they include)? For example, does your fee include laboratory tests?
43. Do you give me a partial refund if I have to or want to transfer out of your care?
44. Can you help me get reimbursement from my insurance company?
45. What schedule do you have for payments, and can you work out a flexible payment plan for me?
46. Have you ever had to resuscitate a baby?
47. When and how do you perform the newborn exam?
48. Do you make sure that mother and baby are not separated after birth?
49. What kind of support can you give me with breastfeeding?
50. When do you come to see me at home after the baby is born, and what is your postpartum exam schedule?