interviewing homebirth midwife tomorrow...questions?

[shenanegans]

So I am going to have my first meeting with a private midwife and her assistant tomorrow afternoon. They will come to our house and I am wondering is there any specific questions I should definitely ask her? We will have the birth at home if all goes well. If any one has some pointers, I would definitely appreciate it. Wish me luck!

[Dana_305]

Not knowing what aspects of a HB are important specifically to you, I guess I would start with the basics and build off of there:

• What's her transfer rate generally and what's her rate of transfer with a first VBAC attempt
• What interventions she typically uses
• What are common scenarios in which she recommends transport to a hospital
• What's her cesarean rate on a first VBAC attempt
• What special considerations or policies does she implement for a first VBAC
• How many VBACs has she attended
• What's her rate of sucess with first VBAC attempts.
• Looking at the circumstances surrounding your first birth, ask her if she would have handled the situation differently or the same.
• Ask her how long she feels comfortable letting a first VBAC labor, or how far past the EDD she feels comfortable going

I would really ask alot about transfer of care (either before labor or during), what her protocols are and what her limitations are because I would assume that a transfer of any kind on a first VBAC attempt would result in a repeat cesarean. As a mom who transported to the hospital during labor from a birth center (and perhaps that fact alone explains alot about my questions), I wished I had taken the time beforehand to find out what the midwife's procedures were for transport and follow-up after the birth.

[AustinMom]

Everything that is said above, yes, I'd ask, and did ask when I interviewed MWs.

Also, I'd add, what newborn complications she has had to deal with.
How she feels about delaying cord clamping
How much help will she be with Breastfeeding
Her protocol on opting out of Rhogam prenatally, and other prenatal testing
How her births have gone with her kids
Most importantly, how much she knows about fetal positioning. Not just breech vs. head down, but also anterior vs. posterior, how to turn a baby in labor and different positions, how to recognize a baby that is turned funny and stalling labor and how to help rotate him. Fetal positioning has a lot to do with how a birth goes. You can have a great pelvis, small baby, and strong contractions, but if the baby is asynclitic, then it can cause what would be a quick labor to be very prolonged, and recognizing this early can mean a lot when it comes to maternal exhaustion.

[Dana_305]

Originally Posted by AustinMom

Most importantly, how much she knows about fetal positioning. Not just breech vs. head down, but also anterior vs. posterior, how to turn a baby in labor and different positions, how to recognize a baby that is turned funny and stalling labor and how to help rotate him. Fetal positioning has a lot to do with how a birth goes. You can have a great pelvis, small baby, and strong contractions, but if the baby is asynclitic, then it can cause what would be a quick labor to be very prolonged, and recognizing this early can mean a lot when it comes to maternal exhaustion.

It's funny, my section was due to bad positioning and I hadn't even thought to ask about re-positioning when responding.

[shenanegans]

It went really great. They were both very informed and answered all my questions. She has been a midwife for 12 years, in that time she attended 25 vbac births and only one had to be transferred but after many days of labor so in the end the mom had another c-section.
She and her assistant have both had vbac's as well which is interesting and nice to know that they know about it on a personal level as well.
I feel much better knowing that they will be here.

[Dana_305]

Awesome! So glad it went well! ITA that having care providers who have VBAC'ed themselves definitely lends some credibility to their position that you just can't find in someone who hasn't been there.

[AustinMom]

Originally Posted by Dana_305

Awesome! So glad it went well! ITA that having care providers who have VBAC'ed themselves definitely lends some credibility to their position that you just can't find in someone who hasn't been there.

I couldn't agree more. Our MW had a CS with her first because the baby was asynclitic, and her second baby was an HBAC, exactly what we had happen, and what we plan to happen. I think they are better at recognizing the emotional barriers that go on with a VBAC than a MW who hasn't VBAC'ed would be able to. Also, our Doula is the local spokesperson for ICAN here, so that helps A LOT too.