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?)
{ 22 comments… read them below or add one }
So where there any other questions that the Hubby would have asked? Mine always comes up with questions I would have never thought of.
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?
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.
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.
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
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!
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!
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*
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).
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!
Those are really great question! Now, if only our state regulations allowed midwives such freedoms!
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.
Love these questions. Another that could be added is: how does the midwife feel operating with no ultrasounds/scans being done?
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
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.
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.
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.
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
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.
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.
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
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.