Home Birth: Questions to Ask When Choosing A Midwife

There is so much excitement and anticipation while you await your baby’s arrival.

He or she is barely the size of a peanut and already your head is spinning around the clock wondering about what kind of person he will be, what will you name her, how will you decorate the nursery, which car seat is safest, and OMG—why are there so many opinions on what I should do with my placenta?

There are also options regarding where you choose to have your baby—hospital, birthing center, or home—and if you have decided to birth your baby at home, there are some things you will want to consider when selecting a midwife.

Here are some questions to help you get started:

Do I feel comfortable with her? As a midwife, part of my job includes educating you about self-care throughout the prenatal, labor, birth, and postpartum phases of your pregnancy. The most important act of caring for yourself will always be to trust your intuition, and trust your body. That starts here. Is this midwife a provider with whom you can develop a trusting relationship?

What’s your style? Every midwife has her own style. Some of this you may have already picked up on just by first impression, but a good way to find out more is to simply ask… What’s your style? What’s her communication style? Leadership style? Do they mesh with your own? Maybe you need a calm and gentle guide, or maybe you are seeking someone more assertive who will be firm with you—either way, now is the time to ensure a good match.

How many births have you attended? How many women do you see annually? I recommend selecting a midwife that has attended at least 100 births. The amount of women a midwife sees annually varies greatly depending on the size of her practice, if she does solely home births, or if she also attends births in a birthing center. The important thing is, are you comfortable with the amount of experience she has?

How many women are currently under your care? This may or may not be a deciding factor for you. The fact that you are interviewing this midwife should imply that she has room in her schedule for new clients, but her workload will affect her availability. It is important to know if she is caring for other women with similar due dates and if your labor and delivery coincide with another client, how will that be handled?

Do you work with other midwives in the area? The midwife you hire will be the face you see most often throughout your pregnancy and routine prenatal care. Just as important, whose face(s) can you expect to see in the room when your baby’s birth day finally arrives? Who would respond if she is unavailable in the event of another birth or personal emergency? Will another experienced midwife or a student be present to assist with your delivery?

What is your transport rate? Meaning, how many laboring mothers were transported to the hospital under her care? What were the conditions under which she made those calls? This rate varies between midwives, as do reasons for transport—sometimes complications arise but my experience has been, more often than not, Mom is exhausted and requires rest via an epidural or drug therapy in order for her labor to progress. Regardless, it is good to know going in, under what conditions would she advise you to go to a hospital?

What type of training do you have? If your state requires licensure, is she in good standing? There are Direct Entry Midwives, Certified Professional Midwives, and Certified Nurse Midwives. DEMs are trained through apprenticeship. CPMs received educational and clinical training through a MEAC accredited institution along with apprenticeship, and have passed the NARM certification exam. CNMs are Registered Nurses who have also received midwifery training.

What types of unconventional births or pregnancies have you been a provider for? For instance, has she delivered breech babies? Twins? Vaginal birth following a cesarean (VBAC)? What did she, or would she do in those instances? My belief is that midwives should, if they choose, hone these skills—they really are lost practices of art and home birth should be an option for as many women as possible.

What are your rates for service? Michigan rates generally vary between $3,000-$6,000, and there are usually payment plans available. What this rate includes is unique to each provider, but generally speaking, they should pay for all prenatal care, labor and birth, and postpartum care. Personally, my rates cover unlimited communication, prenatal care (including urinalysis and blood draws), labor and birth (including setup and use of pool), newborn screening (i.e. metabolic, hearing, congenital heart defect), and postpartum care, which consists of a day 1 (24-36 hour post-birth) visit, followed by visits on days 3, 7, two weeks, and six weeks with a physical exam including a PAP.

This guide should give you a good start to finding a midwife that best suits you and your baby’s needs. Trust your intuition…Mother does know best!

This content is intended to be informational and should not replace the advice of your physician, midwife, or other qualified provider.