Written by Svea
Just last week I had the privilege of meeting with two fantastic midwives. Recommended by a friend, they are the women I hope will accompany me through my second pregnancy and delivery. They are kind, empathetic, knowledgeable, and funny. Exciting!
When I told my husband the news, he had a lot of questions. Most of them (“How much does it cost?” and “Do they know what they’re doing?”) I could answer. But some, I couldn’t. Hubby wanted to know exactly what they would do in an emergency – “Tell me about a time when things didn’t go well. What did you do?” and, “Have you ever lost a baby? Why?”
I got all defensive and said that well, I had asked the questions I thought were important, and I’m pretty informed about birth and doesn’t he respect anything to do with intuition? Then I got mad and started defending the scientific realities of emotional support (emotionally supported births are not just happier, they’re healthier!) and he said something about how he’s always the one asking the hard questions and it turned into a whole late night conversation that, I guess, we’d been needing to have for a while.
But anyway, I thought I’d share some of the questions I asked in the interview. The query of what to ask a potential midwife used to come up a lot on the BWF support group (and probably does now on the BWF Fans group, but I’m left out because I’m not on Facebook, *sniff*); some of the items below are taken from those conversations. I personally think that ‘goodness of fit’ is the best thing to look for, but we all have to decide what that means for ourselves. The first few are the questions I asked (and the answers that made me so happy).
- I plan to refuse almost all vaginal checks. Like, maybe I’ll allow one. What do you think about this? (they don’t check unless the mama requests it! woot!)
- Are you familiar with other ways of assessing dilation? (yes, e.g. vocalization)
- Do you deliver breech? Do you deliver all kinds of breech? Do you have training and experience in this kind of delivery? If not, do you have a midwife you would refer me to if the baby had not turned? (No, but a neonatologist who trained under a midwife in Chile works at a hospital nearby and he does)
- Do you have experience with turning babies, not hospital version-style? (Yes – almost 100% success rate)
- At what point would I get ‘risked out’ of your practice, e.g. how many weeks ‘overdue’ could I go before you transferred my care to a doctor? (As long as baby’s healthy, as indicated by Non-Stress Tests, you can stay with us)
- What do you do in the case of a nuchal cord?
- Speaking of cords, we intend to do delayed cord clamping. What do you think about this?
- How long have you been practicing midwifery?
- Why did you become a midwife?
- What is your training/education/certification?
- Will you deliver the baby, or will you assist me in birthing him/her/them?
- Do you have experience and recommendations for prenatal nutrition?
- Do you deliver twins?
- Are you connected to a natural birth/natural parenting community I could get to know?
- Do you do the Gestational Diabetes screening? Is there an extra cost associated with it? Do you ‘allow’ your clients to eat a specific meal before the test, or do you make them swallow a sickeningly sweet orange drink?
- Do you continue to see clients with Gestational Diabetes, or do you refer them to an obstetrics practice?
- How much do you charge, and by what date would the full amount be due?
- Do you accept payment plans? What is your refund policy if we decide to switch care providers?
- How often do your clients succeed in having their health insurance provider reimburse them?
- Do you work with doulas?
- Do you work with birth photographers?
- Who is your back-up pair of hands/midwifery assistant? When can I meet him/her?
- What is your hospital transfer rate?
- Do you do routine episiotomies? Do you do any episiotomies?
- What equipment do you bring with you to a birth? Are you legally allowed to carry Pitocin (for rare post-birth hemorrhaging)? Do you?
- Are you trained in neonatal resuscitation?
- How many births do you take on per month/year?
- Are you planning any vacations, trips, major surgeries, or other events that would interfere with your attendance at the birth?
- I am an abuse survivor and this may affect my experience. Do you have training in counseling or other trauma-healing work?
- What kind of postpartum care do you offer?
- Do you do placenta encapsulation? Is there an extra charge?
- Do you facilitate water birth?
- What methods of pain management do you recommend?
- My partner has x, y, z fears about home birth. How have you dealt with this in the past?
- What is your preferred method of communication, prenatally (phone, email, text)?
- Midwifery is a challenging profession, and often a labour of love. What can I do to make this experience easiest for both of us?
- Have you had any loss (baby or mother)? Why and what happened?
Also, here are some questions I asked myself after the visit:
- Would you be friends with these people? Why/Why not? (Yes. I hope we become friends)
- Does either remind you of your mother? How do you feel about this? (Not much – and only in the best ways)
- Were you able to ask all the questions you wanted to? Why/Why not? (No – I didn’t ask about hospital transfer rate because I already felt that we’re on the same page)
- How did you feel about the birth when talking with them, compared to how you feel about it normally? More or less excited, more or less anxious? (More excited! Not anxious at all)
- Was the visit enjoyable? (I didn’t want it to end)
- If there were other family members present, what was their experience of the interaction? (My husband was at work but they were kind to my toddler and flexible with his needs)
- Did you sense that either was intimidated by your birth nerdiness and stance as an educated consumer? (Nah, we’re all passionate about birth, why would that be a problem?)
Recommended Reading
Birth Of Elsie {Homebirth Story With Siblings}
The Birth of Sicily Rose {Postpartum Hemorrhage, Vanishing Twin Syndrome}
Dorian’s Birth Story
A Beautiful Family Home Birth/Baby Caught by Grandmother {Graphic Emergence Photos}
Vaginal Hospital Birth of TRIPLETS
My Final Birth Story
Sojourn’s Birth Story- One Woman’s Successful Frank Breech Vaginal Hospital Birth
Surprise Breech Delivery {Home Birth}- Hospital Trauma and Healing at Home: A Story of Two Births (Part II)
62 Comments
Alesia
So where there any other questions that the Hubby would have asked? Mine always comes up with questions I would have never thought of.
Alesia
oh theres some more questions.. Do you have issues with leaving laboring Mama alone until she calls you? Will you wait in the other room, allow Mom to do it on her own ? Is it ok for Husband to catch baby? How do you feel about children being at the birth?
Carla
Something else you might add, if it’s a home birth, is a question about pets. If the midwife is allergic to/has a phobia of your pet, you might need to make other arrangements.
Lilly
As a first time mama I attempted homebirth with LOTS of excitement and complete trust in my midwife. I did tons of reseach and loved my midwife. Closer to the end though I started to feel a bit unease with my midwife but chose to ignore some signs thinking I started to get cold feet. My midwife was still as sweet as can be, that is until I went in to labor…
That’s when the nightmare began.
She was negligent.
She put her needs in front of mine, telling me she had to go eat, sleep, rest, etc….
She abandoned me during a tranfer to the hospital and showed up 2 hours later to and said I should give her a call when its time to push.
I transfered due to negligence and abandoment of my midwife. I was in a dangerous situation, feeling faint, with my labor slowing down after 30 something hours. I was dialated 8-9 cm and closed back down to 5 when she left me. My husband and I went to the hospital on our own. She did not even help me to my car. It took us 20 minutes to get out of the house, the midwife left us saying she will meet us there but showed up 2 hours later. She was supposed to admit us in but no one had any idea we were coming. We could not get hold of her for a while.
She says that I transfered due to “maternal exhaustion”, which is true in a way. She also says that I just did not like the feeling of pain. I labored on my own at home for oer 60 hours without her being there.
If you talked to me, you would find out a different story as to why I transfered. My midwife was dangerously negligent, showed no skill or compasion. She did NOTHING during my entire labor except give me ibuprofen.
If you are interviewing a midwife PLEASE ask for references of women who transfered. Ask their side of the story as to why they transfered and if they feel the midwife had anything to do with it. Women who had babies not longer than 4-6 months ago. Don’t talk to one or two references but ask for 3-4 or more. Talk to as many women as you can to get the feel of how this midwife will be while you are actually in labor.
Amy
Lilly, Ugh…your story brings back some memories for me as well. I ignored those feelings as well in the last few weeks and thought I was just getting nervous. I sure hope our next deliveries go much better! xoxo
Leah
Wow Lilly its so sad to hear your story! I can’t imagine the disappointment! I had a home birth for my first baby as well and had a hard birth but even tho my midwife was at the hospital with her son and couldn’t be here her backup showed up and I felt completely comfortable! I hope you give homebirth another try if you can find a midwife you can trust! I loved being in the comfort of my own home and after hearing some hospital stories that scared me I feel so much better at home! 🙂
Courtney
Asking for references from moms who have transferred is an excellent recommendation.
lauren
omg i had almost the same experience with my first. 30 something hours of labor, 3 hours of pushing, assistant even told me to be quiet. it was a really hard experience that i thought was going to be so magical. i thought i was having a home water birth. ended up screaming for hours on a bed due to him being stuck. my water broke at the start of labor. should of been offered antibiotics, never was offered. My son contracted Bacterial Menengitus and we spent a month in the hospital. I was heartbroken. all this being said though i went on years later to have my daughter at a birthing center and while my water broke again too early i got the antibiotics, allowed to come and go as i pleased, labored in the water, and had her out in 3 pushes. and shes didnt get sick.. i love love love my widwives. but sometimes its just not the right fit and we mothers suffer. wish i had been more informed as a 22 year old then i was at 26 as to what to ask about. i know part of it was me being young and being swept up in what i thought was going to be fact.(ie: laboring quietly, “breathing” my baby out silently, baby magically popping right out).
Wholistic Midwife
I am so sad. I know there are times when midwives are having to take care of two mamas at once. i had a birth were Ihad to take a mom to the hospital and then left and was called to another mom. I didnt get back til after she delivered(which was very fast after sleeping in the hospital for sevaeral hours, which I stayed for ) but she was mad. But this is rare. These are sad stories to read.
Jenny
Wow, I am so sorry this happened to you. You offer some very wise advice.
alissa
I also had a bad experience with a midwife. I chose her only because she was the only one who would do a waterbirth. I had my son in the hospital (my mother said no to homebirth..it was their home so I respected that) anyway..it was her day off so she had to be called to come in. Well I spent the whole day in the water only getting out a couple of times and the nurses kept doing cervical exams (and they were wrong on how far dilated I was) they broke my water 2 times. But everything kept closing back up.later that night the midwife shows up has me push a couple of times then says ok get out and we are going to induce.. all hell breaks loose!! It all went down hill from there! I had an epidural after many hours (contractions with pitocin are 10 times stronger than normal) the guy is trying to put needle in but cant because im to swollen from being in the water for to long (he is cussing the nurses and midwife) he finally got it right and I rested for awhile. They asked me to push again (i only did a couple of pushes) nothing..ok we are going to have to do a c section. They put me to sleep so I couldn’t even see my baby when he was born. I was the last to hold him. When I finally woke up they had given him formula (I wanted to breastfeed immediately. .he is 2 and he is breastfed) I expected more from her. She was called that morning when I showed up and didnt even show up until later that night. There was 1 other woman in labor that night she had her baby before I did.
The midwife started my labor 1 day past due date…I think that was a mistake I dont think he was ready to come out and that is why I had such a hard time to start with. I think if I had said no and waited on him It would have been a natural waterbirth.
Rebekah
That’s horrible! I’m so sorry that you had to experience that. I hope you filed a report against her, her behavior was totally unacceptable.
Cassidy
I love this list! The best I’ve seen so far, many just ask medical and statistical questions but this list went beyond that! I have my second meeting with my midwife on Thursday and I will be asking some of these. Thank you so much!
Svea Boyda-Vikander
These are all great suggestions – I’ll add them when the post has been up for a few more days. Keep ’em coming! 🙂
Lilly, I am so sorry to hear about your experience. Labouring women need support! Even if that support sometimes means, “Don’t touch me, don’t talk to me, wait in the other room.” It’s about respect. I hope that if you have another baby the L&D is everything you need. *Hugs*
Samantha Bice
GREAT list of questions! I would also add in the payment area “Do you take trades or alternative payments?” (like, can I knit baby hats or can my husband do electrical work for you, etc). Many midwives will take trades and this can greatly reduce the “out of pocket” cost for families. I know one women who paid for her birth (except the tub rental) totally with trade (her husband did electrical work the midwife).
SRB
Excellent list of questions Svea. I can empathize with the husband asking the ‘hard’ questions as Brad definitely does this at our visits and it makes me feel angry/defensive, but I recognize that he is being realistic and protective of us.
I also appreciated the questions to ask yourself, to make sure you are keeping in touch with your gut feelings about, well, your gut and not just creating the kind of environment you want to have.
Are you guys planning a home birth this time? The new birthing centre in Toronto won’t open until July so a home birth it is!
tammy
Those are really great question! Now, if only our state regulations allowed midwives such freedoms!
Janice
Thank you so much for sharing your thoughts/questions. You will help many other women in their journey of finding the best birth professionals for them.
Donna
Love these questions. Another that could be added is: how does the midwife feel operating with no ultrasounds/scans being done?
Zoe Yates
I had amazing midwives & students (who were also friends & nursing colleagues) with me at the birth of my kids – I am just now beginning along the path to be a midwife and found this list really interesting from the point of “what kind of midwife do I aspire to be?” – thankyou , as always :). PS love the term “birth nerdiness”!! Xxx
Ana
Zoe Yates
Me too!
I found this site looking for some statistical data on co sleeping vs crib sleeping but got hooked on this list, from the perspective of a midwife to be. I know how I want to answer these questions. My heart goes out to women with sad birth stories. Ever since the birth of my daughter, which went horribly unsupported by those around me, I have wanted to be a midwife to be the loving and supportive help a family needs at this incredible moment in their lives.
L
I like the ideas brought up at the beginning and the end BUT it seemed like at least half the questions could be easily found on a MW’s website. It’s also concerning that the questions are so leading- they’re phrased so that you are basically telling the MW the answer you want to hear. “Do you do routine episiotomy?” Well even the most cut happy OB rarely would admit they do “routine” episiotomies, but if you asked them when do they think episiotomies are needed and just that with no clear opinion of your own expressed, well suddenly that doctor “ONLY” does episiotomies on first time moms, moms who had them before (apparently with same dr lol), when baby doesn’t slip immediately out, when the baby “seems” too big, etc. So basically anyone and everyone who doesn’t just have kids plop right out, aka “routine”. Also seen a MW interview suggestion list that said to try to be opposite of what you want to see how much they just “play to the customer”. So if you want a liberal “everything’s a variation of normal” MW act like you want a strict conservative one who considers transfer over the slightest whisper of an issue or vice versa.
To Lilly, so sorry that happened to you! I had a similar experience though luckily mine worked out a tad better. I had a MW who seemed great at onset but then kept getting little red flags from. I continued care but birth just really brought out her true colors. Very impatient, unconcerned, fearful, pushy and in my face- I really wish I had changed to a different MW but I had been with her from the start and didn’t to rock the boat, especially bc I didn’t start considering it until well into 3rd trimester. When I tried to discuss my experience with her she just blew me off with a glib apology.
Svea Boyda-Vikander
It’s true that open-ended questions, in any part of life, will give you better information than closed ones. People are more thorough and honest when given the chance. It takes longer, but is probably worth it.
About the suggestion to pretend to be the opposite of the kind of client you are… I would never do this. The relationship between care provider and client is valuable – it’s (almost) everything. And it’s hard to establish that relationship with any kind of dishonesty on either party’s side, whether it was for strategic purposes or not.
Also, MWs need to have some lee-way to give individualized care. Women who want to transfer to the hospital at the slightest whisper of an issue should be able to do so; if I were a MW (and I would be a liberal one!) I would follow my client’s lead in this.
Mel
It’s great to have questions for the midwifes and such. But watch how they answer them. I have had a lot of midwifes lie to me and it is soo very frustrating.
Kayla
Not all of us are privileged to live in a place where midwives are available. There are two in the entire province of approximately one million people where I live, unfortunately not available for hubby and I.
Dh is not good with an unassisted home birth (at all… this is baby #1) and his parents (trained in the medical field as ambulance drivers/paramedics) just about popped their eyeballs out of their heads when I mentioned home birth……. Needless to say I have bent to attending a GP that does deliveries and pre-natal care and will birth in the dirty “h” word. I would love a list of questions for my GP 🙂
Mrs. BWF
There are wonderful doctors, you just have to find them. I currently have a friend who is driving 2 hours 15 minutes to be under midwifery care as well. 🙂
Melissa
I think you can have beautiful births in a hospital! Make sure you and your husband are educated, know your rights and hire a doula.
Abbie
I definitely agree. My son’s birth didn’t go quite as planned, but the experience as a whole was beautiful. I was not rushed by the nurses. They were encouraging and very informative while also maintaining respect for my preferences. There was even a rain-head shower head in the bathroom in my recovery room. I felt as if I had given birth in a spa with the rock walls and the rock bench to rest on while I cleaned up. They were INCREDIBLE! (Ridgeview Medical Center, Waconia MN)
My first experience was traumatic, neglectful, and damaging to myself and my daughter. Not all Dr’s and nurses go above and beyond, and it shows. The nurse dislocated my daughter’s hip just after birth. She was never secured with her “hug” to my “kiss” security system. They were HORRIBLE! (Glencoe Regional Health Services, Glencoe MN)
Now, I seek a home birth or a birthing center this time around. I know what I want and what I refuse to put up with this time around. That should take me much further than my first experience with my daughter.
Annvan
I would ask if they carry malpractice insurance. Do they participate in both private and group supervision on a regular and formal basis? Where do you find information about the practice of midwifery such as scope of practice in your province or state. How and where are complaints made.licensing board, national or state/province midwifery group.
I’d like to think that I would ask about past complaints or legal actions that are birth related.
If the midwife gets defensive about these questions I wouldn’t continue with her.
April
I would add too WHY you are asking about pitocin and some of these other questions (so people know why they should ask ie to stop maternal hemorrhage). A good friend of mine just delivered with a midwife who had no formal training and was TERRIFYING at the labor. She tried to SUPERGLUE (no gloves, no sterile ANYTHING) a very bad vaginal tear!!! Anyway, beforehand I gave my friend a similar list of questions to ask and she threw out several of them because all she had ever heard was that pitocin was bad! Honestly I hope those that are reading up on this site would know more than that BUT some first time mom’s don’t, or are just starting their education here 😉
Stephanie Vaughan
I haven’t had a home birth (yet), but I love the idea to get references from moms who transferred. I would also ask: What do you do in the rare case of (actual or suspected) uterine rupture? (I’m a VBAC mom, but others might consider this, too). If there are ANY other birth complications that you are specifically scared of, in addition to working through your own fears, ask what the midwife would do with those. I also REALLY think it’s important to ask where you could bring complaints if you had them… and then check that source to make sure there are no outstanding complaints. If there is nowhere to do this, that ups the need to trust that midwife and I would strongly recommend leaving at the first red flag. In addition to pitocin, you can ask if they carry oxygen/how they perform neonatal resuscitation if needed (and when do you consider it needed?). Ask to see their neonatal resus credentials and also their assistant’s credentials in this area. Of course, all of this is after/in addition to the more emotional/philosophical fit questions, which are essential.
Courtney
I received amazing prenatal care from my midwife. I was very educated about birth. After transferring from the birth center and ending up with a c-section in the hospital these are the questions I will ask my next midwife.
1) What role do you play during labor? As a first time mom I just needed some good ‘ole fashioned, “you’re doing great” positivity.
2) If the situation gets to a point where you are deciding if intervention is needed how will you communicate that to me or my husband during labor?
3) If I transfer what role will you play? Later I told my midwife how alone we felt in the hospital. She explained she is trained in natural birth and doesn’t really know how to respond in those situations (a mom stuck in the bed with pit and an epi on board). It would have been nice to know this before I went into labor. My worst fear was coming true, and the only person I know and trust is mostly silent.
4) If I transfer is there a hospital you recommend I transfer to? I was given two options when it was time to transfer. I had been in labor for almost 40 hours, and I was in transition. The recommended hospital was 45 minutes away. The other hospital was 10 minutes away. I felt like I was dying. I said get me to the closest hospital! This was not the time to have this conversation. I needed to know this information before going into labor. I found out that the closer hospital doesn’t really work with the midwives from the birth center (even though that’s how it had sounded originally). They wouldn’t talk to her. They were asking me all the questions. It was terrible. My midwife told me later if she could have ridden in the car with us she felt like she could have gotten me through the 45 minute car ride, but she eventually has to go home. I thought about this a lot, and if the only thing potentially keeping me from the negative experience I ended up having was a car ride back to the birth center we would have paid for a cab!!! It would have been worth every dime! Again a conversation we needed to have before labor.
5) What is your postpartum care like? Are you able to provide additional care/support past the typical 6 weeks? How do you support moms who transfer? I was devastated from the loss of my natural birth center birth. Breastfeeding fell apart. My placenta was infected and couldn’t be encapsulated. I had so much grief to work through.
6) If I transfer and the hospital claims go through first when will I get a refund from money prepaid to you? This sounds silly, but it became a huge issue after my birth. I more than reached my out of pocket max on my insurance by the nearly 40k billed from the hospital. Their claims went through first and the bills from the hospital started coming in. I had already prepaid my coinsurance to the birth center. It took 5 months to get the full amount of money back….months after the hospital had already been paid. I don’t know about most people, but double paying my coinsurance to the tune of several thousand dollars put a huge stress on my family financially. It was already a fragile time anyway. To add insult to injury I was told they were well within their legal right to hold my money for so long. They paid themselves from my refund. I asked for clarification on some of the items, and they never got back to me. I guess they got their money, and didn’t see a need to communicate with me anymore.
Looking back I was really educated about natural birth. I was not prepared for a hospital transfer and definitely not a c-section. I could have never imagined the heartache and sadness I would experience from my birth experience and fall out with the birth center. There are so many things I wish I could go back and redo.
Sherri Holley
As a Midwife of 34 years I appreciate these questions. As either a birthing mother or Midwife I feel these are great comprehensive questions. I have seen too many women not get good care because they didn’t really know their caregiver.
Courtney
I am very early in my first pregnancy. I will be seeing a CNM (my insurance covers that). My goal is to recover quickly from the birth, which means I absolutely want to avoid drugs, and do not want an episiotomy. Those of you who have delivered in hospitals (I will have to for insurance), have you had any luck refusing an IV drip? I see no medical need for the drip, only the IV catheter for an emergency situation. And advice?
Bethany
Just refuse it. Say no! Hospital policy is not law. A patient has the right to refuse whatever they want. You might have to sign a refusal form, but you have the right to do, or not do, anything you want. As long as you drink water or an electrolyte drink during labor and stay hydrated, there is no reason for I.V. fluids. The nurses and doctors may say you can only have ice chips, or that you can not eat or drink anything just incase a c-section is necessary, that’s not true. You can eat or drink whatever you want. You are still a human being with rights and the ability to make decisions for yourself. You don’t have to give up your decision making authority just because you are a patient in a hospital and someone in scrubs says otherwise. It might seem like you don’t have a choice, but you ALWAYS have a choice. They may try and say they will only connect the I.V. and have it running slowly just to give you some fluids, they may try and scare you into it, they may say that the baby needs the extra fluids, or say a number of things. If you don’t want it, don’t allow them to give it to you. Research why interventions are done, including I.V.s, and when they are actually needed. Research what determines a baby is stressed. Research what issues with mom or baby require an intervention to save a life and what issues do not require interventions, even with medical personal saying so. Know what happens when and why it happens to you and baby throughout labor, delivery and post birth. Ina May Gaskin’s book Guide to Childbirth is an amazing read. I also recommend a Hypnobirthing class, or at least read the Hypnobirthing book. If you have your heart set on a COMPLETELY non intervention, drug free, natural birth, Ina May Gaskin and Hypnobirthing can be of tremendous help. I am so glad I was able to birth my baby at a birth center, even though I was a nursery nurse at a hospital before I was pregnant. I stayed home as long as I could. I got to the birth center at 9 cm. Baby was born less than two hours later via a waterbirth. No I.V’s, no interventions, no meds, nothing, just me, my baby and my wonderful support team of my husband, midwife and nurse, and it was absolutely AMAZING! You can have the birth experience you want, just do your research and be cautious of putting too much trust in anyone besides yourself and your baby to make the right decisions for you and your baby during this amazing time in your life. I have heard many stories about women who just completely trusted their midwife or doctor and never learned about the birthing process for themselves. Things didn’t go as they had wished, but they didn’t know there were other options. Because they trusted others to know it all for them, others ended up making decisions for them. YOU are the one giving birth, YOU are the one experiencing a small human coming out of your body, make sure to have an understanding of what is going on with YOU.
Sue
Courtney,
I had no luck refusing an IV drip with my son. That said, when the nurse that insisted on it left at the end of her shift, I took it out. All it was at that point was fluids and I was healthy – didn’t need any meds. prob depends on the hospital/Dr/staff. I’d bring it up with the Dr if you have a strong opinion on it. Anything you have a strong opinion on I’d bring up & also make sure anyone present at your birth will help see to your wishes. When I was busy with my son crowning, my Dr used my distraction to go against my birth plan on some stuff – doula knew & tried fight but my Aunt didn’t & defended the Dr. I was in the zone & the scenario didn’t even permeate my ears….
Great list.
Emailing the list plus a few of my own questions to my partner for him to add to it by the next meeting. Don’t for see any problem with the birth but none of us ever do till it actually happens 🙂
Ones to mention on here, I have a Dr I have seen twice now.
If you’ve seen a Dr, ask the midwife if she knows of him/her, opinion of them, who else they would recommend (mine has highly recommended this Dr as a emergency backup) and also if it’s OK for the Dr to know she’s involved….
– Do you use any natural methods to speed up the birth or to kick start a late baby who is too comfy? My son was induced w/ mineral oil 3+ weeks late… man did that work!
– Should we register/do paper work with the hospital just incase (Murphy’s law repellant)?
Janna
Courtney,
I’m in Australia so things might be different here, I would think that no one can force you to have the drip? I would make a clear plan and ensure that all of your support team knows what you are and aren’t willing to have. A great site I found is evidencebasedbirth.com for all the stats that you can throw at the docs 🙂
Rachel
Am in Nigeria, and had my first baby in November 2012 through a C section and now am 5weeks pregnant and still breastfeeding, what should i do, does my breastfeeding has effect on my 11month old baby, should i stop or continue breastfeeding.
Please i need advice urgently.
Elena
Rachel, it won’t hurt either of your babies for you to continue breastfeeding while pregnant. Many women do, and some continue to nurse both their older child and new baby at the same time. I would just keep a close eye on your milk supply and make sure your 11 month old is still getting enough, as pregnancy can sometimes cause your supply to drop. If you feel he/she is not getting enough milk from you, definitely supplement with formula or increase their solids to make sure they are getting enough nourishment!!! You’re doing great, mama 🙂
Ruth
Excellent list of questions, thanks for posting this.
Aislinn Burton
A couple more I came up with.
Do you routinely test for group b strep?
If a mother is positive for group b strep will you still provide care?
Danijela
I became friends with my midwife. She’s the only person i feel comfortable with having lunch with and talking about my vagina!
Birthdance
I am a practicing midwife and when I set up an interview I make sure that the partner, husband, main support person or grandmother is there. Whoever is going through this process with the pregnant birthing mama should be there. The first two paragraphs in this article are the reasons why, the response to the questions should be heard by both. I will schedule appointments around work schedules to allow all involved persons to be there. If it’s her 4-5th baby and its easier for just her to come in then I will explain that I will not enter into a professional relationship until I meet the partner, husband , etc. I have helped single mothers and usually they have a support person with them. I LOVE it when families come in with questions, the above is a great start to building a personalized list!!
Aurelas
Based on my experience, which I really don’t feel like actually describing as it is more like a horror story than anything else, I would add a few more questions:
Will the midwife put both hands inside you? Will they let you know before they do it? If it hurts, will they stop?
If you have not dilated fully, for instance if you are stuck at 8 cm after almost a week of labour, will you be sent to the hospital or given a shot of pitocin?
If the baby is stuck, what will be done? What methods does the midwife use and when does she call the hospital?
If you beg for the ambulance will it be called?
If you need an episiotomy, will there be any anesthesia? The books I read say it won’t hurt because it will only be done while you are having a contraction and the skin is stretched tight. That is not what happened to me AT ALL. And then the cut had to be widened on each side and I got nicked by mistake too. I remember it as white hot pain that blinded me and raged as the midwife continued to shove both hands inside me after it had been done. If contractions have stopped or the midwife can’t tell when they are coming, a shot of anesthetic like my sister was given at the hospital would definitely be better than nothing. Heck, even Tylenol would surely be better than nothing.
If your baby shows signs of jaundice, will you be told? We weren’t, and stupidly thought our baby had inherited the darker skin genes from my Native American ancestors. A few days later and our baby wasn’t eating, wasn’t waking up, and we were in the hospital with her fearing for her life.
When you finish giving birth and everyone is cleaned up, baby measured, etc, when will you be sent home? (if you are at the midwife’s house/clinic) Be wary of anyone who will send you home within hours. It might help to talk to someone who has given birth there before, because our midwife had made it sound as if leaving the same day (or night) was an option, not a requirement.
When you go in for your checkup afterward, will you be examined to make sure stitches are healing properly, etc, or will the examination be entirely a series of questions? With me, it was a series of questions, so it came as a huge shock when about a month later my cervix turned itself out and my rectum pushed up. I actually thought my uterus was prolapsing! Note: make sure you know what cystoceles and rectoceles are! Not a single birth book I had read mentioned them and neither did any of the Healthy Start birth classes we took or meetings I went to beforehand.
I don’t want to scare anybody, but I wish I had known to ask these questions before I gave birth so I could have made a different choice.
Nechama G
I am a former homebirth midwife, and I think the questions are great. However, I really want to comment on the under-laying expectation I see in some of the comments that having a midwife will equal empowerment, a good birth, a spiritual experience, undying support etc. I don’t want to in any way excuse negligent or ignorance or negate the truth of anyone’s experience, including the stories some people shared of what sounds like neglience and harm-I’m so sorry for those experiences. However, midwives are just people. Most of us are good at our jobs, some of us are not, and all of us have bad days and good days. All of us have times when we are exhausted and not at our best, and times when we don’t communicate effectively. Women certainly have the right to expect competent care, to be heard, to have their needs and values honored, and to have the midwife fulfill her contract to the best of her abilities. However, having a midwife does not guarantee a good birth, a professional relationship that meets all your needs, an empowering birth or even a home birth. Having a midwife will not make you more natural, wiser or a better parent. A midwife is not your friend, mother or spiritual teacher. She is just a fully human person with whom you have a professional relationship. As a midwife, I strove to be honest at all times and to never mislead clients in any way, and to have good boundaries. At interviews, I sometimes felt like people were wanting more from me than I could deliver, and there was this unspoken expectation that I would be much more than a trained maternal child health professional, that i would be somehow a statement about the mother’s identity or dreams as a woman, that I would make her a better mother or a more “natural” woman if she “achieved” the goal of homebirth. I tried to be very upfront at interviews, and said things like “in the end, birth is just one day, and while my goal is to monitor your health and your baby’s health, and to make you feel heard and cared for in labor, what you do on that one day doesn’t say anything about you as a woman or a mother. I can’t give you a spiritual experience or an empowering experience; I can just monitor your health and support you in your choices.” I think we as a birth community need to stop overselling midwifery care.
Bre
Bravo!! Yes birth is a major experience for women to have but you need to remember the ultimate goal is a health mom and baby at the end of the day. You might not agree with all of your provider’s decisions but you need to remember they just want the baby to arrive safely. If you begin to question this as their end goal then you need to change care.
Bettie Sheets
Reading through this post as a midwife brought up a lot of emotions. I at first felt that most of the questions were good, though worried about the fact that a lot of standard questions about birth practices really amount to nothing if we expect a birth professional to look at each woman individually. A “right” answer for one situation could end up being a very dangerous answer for another.
In reading through the comments, I had two reactions. First, sadness over the lack of education and professionalism of some midwives. Second, sadness over the unrealistic expectations that women have for midwives. I would venture to guess that homebirth midwives are prone to burnout more than most professions. We leave our families not just for scheduled work hours, but for unscheduled births that can sometimes take days to be completed. We miss great quantities of sleep, even just answering late night texts for women having little problems or getting labor updates. We have to transfer women in sometimes hostile conditions. I have a great rapport with nearly every current and former client I have. However, I make no apologies for going home to sleep in my own bed for a few hours while a client, who is under the care of physicians and nurses, sleeps with an epidural in place or who waits for an inductions to begin. I may have other women who need me calling at any moment. I don’t sacrifice one woman for the other, I do what I have to do. I also do all of this for pennies an hour if you break my fee into an hourly rate. I do what I do out of love for my clients and passion for the art of midwifery.
I echo Nechama, we are midwives and are also human. We make great sacrifices, but if women want us to be there when they need us for years down the road, we have to be allowed to set boundaries. If we don’t, it is the women who lose out and a lot of midwives who look disinterested or neglectful are just plain tired. Midwives have to stop pretending that they can do it all and build in self-care and boundaries into their practice standards so that women don’t have unrealistic expectations.
Erin
I think that both you and Nechama are right on about some of the unrealistic expectations these comments seem to touch upon. It’s important to discuss with a potential midwife things like when will she come to the labor, and will she stay the whole time if it lasts x amount of hours? That way both parties are prepared for the other’s expectations.
For my part as the client of a homebirth midwife, I try to remain aware of the limitations of my midwife, and not place too much of the onus on her. I know I am SUPER excited, and a very high communicator and that if I don’t spread my excitement and questions over all of my birth team, then my poor Marcy would get burnt out on me, I am sure. I spent a good deal of money for a doula who does 3 prenatal visits in addition to the birthing and one postpartum visit. She is on call for me just like the midwife is, and when the question isn’t strictly medical, I can talk to Marni about it. I try to be flexible about my prenatal appointment scheduling as well since my midwife comes to my home. I let her make the schedule based on when she is seeing other clients in the area, and I respect that she tries not to make appointments on weekends, despite the fact that weekends are ideal for me. I do however recognize that I am in a somewhat privileged position, being able to afford a great doula, having a very invested husband, and the flexibility with my job to allow me to take off for my prenatal visits.
Erin
At my first appointment with my new midwife (we recently switched from a birthing center to a home birth at 28 weeks), I asked her what she knew about the health benefits/reasoning behind eating the placenta. 🙂
I also asked her what methods she used to prevent tearing, and about her weight gain recommendations.
Amy Puckett
I love this. Thanks for sharing! I was lucky when I found my midwife, she was exactly who I would want to help me birth my first baby at home and she answered every one of my questions with the answer I was hoping to hear. We agree about many things and I am thrilled with the idea of her helping me get through this. Honestly, I cannot imagine anyone else!
I asked most of the questions above and the rest we have already discussed. I feel totally safe and not anxious, nervous or scared at all. This is natural and what we are all built to do, each in our own way.
I want to hear what the author of this article has to say about her own birth experience!
Mama Nez
SVEA BOYDA-VIKANDER – How was the birth? Was there anything you would’ve changed? Do you have a website with any updates? (I’m just now seeing this post). I’d love to see your experiences. My midwife practice recently closed, and I’m currently searching for new midwives! Thank you!!!!
lisa
wow i wished i had asked these questions the first time.. with baby number two i will
San Antonio Doula
This is a great list. I often share it with my birth clients. Thanks and keep up the great BWF!!
-Jessica
Amy
Sorry if this has been noted already, I haven’t read all comments:
I had a home birth almost two years ago. Overall it was lovely and I believe that it was the best choice for myself and my husband. Having said that, I had a “unique” third degree tear which resulted in me requiring (a non urgent) transfer to hospital to have it repaired by an OB. Since I was the “patient” requiring care, my fresh-out newborn (less than half an hour Earthside) was not able to ride with me in the ambulance as this was against their policy. A very rare scenario, but this put a lot of extra stress on our family as my husband needed to load our less than an hour old baby into his car-seat and drive to meet me at the hospital. ? So after my birth at home experience, I would definitely ask the question if planning a home birth the procedure surrounding hospital transfers.
Kayla
Also…
-Is there a maximum amount of hours of labour you are comfortable with? (e.g. I will transfer you after 48 hours of labour)
-When would you transfer me for failing to progress? (e.g. I will transfer you if you have no change in dilation for 5 hours)
-Should I be transferred to hospital, will you inform me how fast you think I should head to hospital and what I should do? (e.g. I will tell you whether or not you should call 999 (that’s English 911) or just drive to hospital)
Aimee
For home birth if you have pet(s) and want them around, make sure they are okay with animals! I am planning on a home birth and wouldn’t dream of making my poor dog go outside or lock her up elsewhere during this. Our pup’s going to be one of my coaches along with my husband and doula! 🙂
Pat
Great questions. I would add that anyone choosing to birth in a birthing center or a hospital ask these same questions in advance and get the doctor’s guarantee in writing so that they don’t pull the, “Oh, its to avoid something serious/it’s an emergency,” statements, when it’s not, just to perform the higher rated C-section fee (anesthesia, etc…additional costs)…
Also, get the names and number of your midwife’s backups (s). There should be at least two, whom you have also met and vetted, and have their direct contact information, and ensure that they are able to show up at a birthing center (have privileges, not just a student midwife flying solo) the moment you can’t locate your midwife, or if they’ve disappeared while you are at home.
Sarah J
After 6 years trying to conceive I finally got pregnant 3 weeks after I contacted http://iyareyarespellstemple.webs.com/ It was simply amazing. I had history of recurrent miscarriages and was also diagnosed with genetic problems but using your system I got pregnant naturally at age 44& after 2 HSGs and 4 negative IUIs including 6 induction Clomid cycles and laparscopy. God will bless you and your good work more and more. I am recommending your program to all my friends.
Persephone de Vito
The question that got to me the most was when you suggested asking if they have any plans to take trips or vacations that might affect their attendance during my childbirth. I was researching because I was planning to hire a midwife for when I give birth. I checked earlier and found out that I’m having a normal delivery, so I’ve decided to go for a midwife. Your question about their attendance got my attention because I won’t be able to move my due date just because they’re not present, so I’ll make sure to hire someone who can guarantee their attendance. Thanks.
Amy
Some of these comments have given me great ideas for more questions to ask. I think it is so important to look ahead honestly at what might cause trauma, and ask those questions to relieve your mind.
For example how long you can labor before she would transfer you. If you really don’t want a hospital birth that is a key one, and then there’s all the nuances and possibilities around that. It requires time to educate oneself!
Another key question I am bumping up against, now at my second midwife experience with my second child, is why don’t midwives talk about the pain? Is this a thing they are trained to avoid? Are they trying to protect us? It seems to me that there are some solid methods out there for greatly relieving or even eliminating the pain (I’m studying Leboyer’s singing method), but why don’t midwives talk about any of these techniques? Or did yours? Maybe it’s just been my experience.
With my first midwives I felt they must have had a philosophy that every woman must suffer through it, and there’s nothing they can do to mentally or physically prepare.
So – ask!
Thoughts?
Amy
Also ask if your midwives will clean you up if you poo! Mine did not, I was unable to do it myself and my husband ended up doing it. 🙁
Kerry Eldridge CNM NP
The idea of having one midwife, who will meet all of your physical, psychological and mental needs and expectations is an old paradigm that needs reexamining. No one human being can be “on” 24/7, 365 days a year. This is not only an unreasonable expectation but also potentially dangerous and will surely lead to eventual burn out and or failure to meet your expectations. Midwives are (should be) highly trained professionals who recognize their own limitations. Look for a group who work together to meet your needs and to support each other so that they too have recovery time, so that they can be at their best when you are in labor. Beyond that, find midwives who you can trust based on their training, and reputation. If you plan to have a home birth, look for midwives who have obstetrician back up and hospital privileges in place, that include a good working relationship with the transfer hospital if that should become necessary. Your midwife should be willing to accompany you and work together with the receiving hospital. Birth is both a spiritual and physical experience. You midwife should be highly trained in the management of a safe and satisfying labor and delivery, she should educate you every step of the way from your prenatal visits to post partum regarding the process, and the best legitimate ways to have a successful uncomplicated birth. She should support your wishes, feelings and ideas, while being 100% honest about potential complications and what she would plan to do about it. In other words, midwives should be able to ensure a safe outcome, while providing a nurturing atmosphere for you, your partner and desired support people.