Three Simple Steps to Choosing a Midwife

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Three steps to choosing a midwife

Congratulations!  You've decided to hire a midwife for your low-risk pregnancy.  Maybe you've even decided to give birth outside the hospital in order to ensure minimum medical intervention.  Now the question that is probably on your mind is, "How do I find a good midwife?"

 

Do your research.

Start with the Internet. Even if you got a great reference from a friend and plan on hiring her midwife, do your own research and find other midwives for comparison. Check out your friend’s midwife on the internet as well. Any midwife worth her salt will have a professional looking website with information regarding her experience, her credentials and how she runs her business. Testimonials from past clients should also be readily available.  Run away from midwives that do not put forth a professional image. That doesn’t mean all midwives should look a certain way or have websites with same feel; however, a midwife is like any other professional service provider and should be evaluated on her ability to present herself and her business in a way that engenders confidence. At a minimum, a midwife you are considering for hire should:

  • be certified through a nationally recognized agency
  • partner with another mid-wife with commensurate credentials
  • have references and testimonials regarding her work

Meet with all potential candidates.

Even if you meet the first midwife and feel she is the one for you, meet all your chosen candidates. You will be surprised at how different each midwife can be and how many different techniques and approaches there are for addressing the various situations that arise over the course of a pregnancy and at a birth. Listen carefully to each one and take notes. Don’t be bashful about openly documenting the answers your candidate midwife presents to your questions. This should not offend her. If it does, that should be a warning sign that this potential midwife may not be the one for you.

If researching home birth midwives, ask the following questions:

  • What is her basic philosophy on birth?
  • How many births has she attended as the primary midwife? What were the settings (e.g. home, hospital, birth center, water birth, etc.)?
  • What kinds of services are included in prenatal care? (e.g. nutrition information, exercise recommendations, in-home care, etc.)
  • What are her office hours?  Can she make special accomodations if you're working?
  • What is her fee, how must it be paid, what does it include?
  • Does she work with another midwife or assistant at the birth?
  • What does she do if two clients go into labor at the same time?
  • How can she be reached? How does she provide for 24-hour access when you are close to your expected due date?
  • How does she handle special situations, such as twins or breeches?
  • Is she affiliated with an obstetrician? What services does he provide to her clients?
  • What standard and emergency equipment does she bring to the birth? What herbs or medicine does she use and why? Also, what equipment does she not carry/herbs or medicine she does not use and why?
  • How does she handle special situations that develop during labor?
  • What is her policy for transferring to a hospital? What is her transfer rate?
  • What medical facility would she use? How long has she used this medical facility for transfers?
  • What kind of postpartum care does she provide? (e.g. frequency of home visits post-partum, baby check-ups, assistance with breastfeeding)
  • What are her birth statistics (e.g. induction rate, C-section rate, etc.)?

 

 

If researching hospital based, certified nurse midwives, ask the following questions:

  • What is her philosophy on natural, unmedicated birth?
  • How many natural, unmedicated births has she attended as the primary midwife? Overall?
  • What is her practice’s C-section rate?
  • How long will each prenatal visit be? How many visits will there be?
  • What kinds of services are included in prenatal care? (e.g. nutrition information, exercise recommendations, etc.)
  • Will you have an opportunity to be seen by the obstetrician(s) in her practice before the birth? What is their typical involvement in prenatal care, availability during labor and postpartum involvement?
  • How can she be reached? How does she provide for 24-hour access when you are close to your expected due date?
  • How long after 40 weeks gestation before she would recommend induction? What is the longest you will be able to wait before an induction?
  • What induction methods does she prefer? What is her experience with natural means of induction?
  • How does she handle special situations, such as twins or breech babies?
  • What are her methods for avoiding and managing a GBS positive outcome?
  • How does she handle special situations that develop during labor (e.g. stalled labor in the hospital)?
  • How does she feel about eating and drinking during labor? What are the policies at the medical facility where she practices?
  • Will she be present during your entire labor until the birth of your child or will she be swapping shifts as necessary?
  • What kind of postpartum care (if any) does she provide?

Feel free to consolidate the lists and ask any combination of questions that seem appropriate your interview and your circumstances. You can never ask too many questions of your childbirth provider and, as they say, there is no such thing as a dumb question.

Listen to your gut.

Your intuition is more valuable that you realize. At the end of your research and all things being equal, hire the midwife who makes you the most comfortable. She may not be the midwife with the longest career; she may not be the midwife with the fanciest office. But she should be the midwife who brings you a sense of calm, engenders complete trust and most aligns with your values and perspectives on birth.

For more information, please visit the websites below:

About.com: Five Reasons to Choose a Midwife for Your Pregnancy Care

NY Times: Mommy Wars: The Prequel

Ina May Gaskin and the Battle for at-Home Births

babycenter: Choosing a certified nurse-midwife

 

Monica Profile Photo FooterMonica is a Certified HypnoBirthing® practitioner serving the Northern Virginia area, DC and some parts of Maryland. Her practice is called NoVA HypnoBirthing® LLC and she provides group as well as private classes.