good questions to ask a home birth midwife at a consultation?

[babybirkel]

Everything is happening kinda fast. I wasn't sure about a home birth for a while (not sure why...) but I am meeting with a homebirth midwife tomorrow morning for a consultation. I had a natural birth at a freestanding birth center with my son, so I am familiar with natural birth and all that, but I guess I am wondering what I should ask the midwife tomorrow. Transfer rates? Etc? BTDT mamas, help me out.

TIA!

[*MamaJen*]

We had a good thread about that recently: http://www.mothering.com/discussions...d.php?t=507722

[AugustLia23]

Why would you transfer?


Of course, it's not gonna tell you exactly their beliefs, it let's you know what some of their constitutions lie.

[Otterella]

I would ask how she handles certain situations that are hot-button issues in a medical setting: twins, breech, GD, pre-e, PROM, PPH, etc. You don't want to wind up getting risked out for something that could easily be managed at home because your midwife was unnecessarily medical minded, but you also don't want to wind up in jeopardy because she didn't take a serious situation seriously enough. Also, her philosophy on pregnancy nutrition can tell you a lot about how seriously she takes whole body wellness.

[LauraCochran]

Here are some of the questions I’d ask a prospective midwife:

•What are her credentials? Why did she choose this CPM, CNM, or DEM over the another credential?
•Is she licensed in her jurisdiction? If not, why?
•How long has she been practicing, and how many births has she attended in her career?
•How many clients does she take on per month?
•Who does she hire for backup if she has more than one birth happening at a time?
•Does she take time off call?
•Does she work with students or apprentices? If so, what is their role in your care?
•Are her neonatal resuscitation (NRP) and basic life support (BLS/CPR) certifications current? Same question for any students and apprentices who she might work with.
•Does she have a friendly relationship with a backup physician, and what are her recommendations for seeing a physician during your pregnancy?
•Does she bill for insurance? How often is insurance billing successful?
•Does she carry malpractice insurance? Why or why not?
•What are her indications for referring or transferring a client’s care? Are these standards consistent with local (legal) protocols? If not, why has she chosen this protocol? (Examples might include attending multiple or breech birth in a jurisdiction which doesn’t allow it)
•What is the rate of transfer of care in her practice? What is the rate of transport from a birth? What is the rate of emergency transport? Of the women who are transported, what is the c-section v. vaginal birth rate?
•Has she ever had legal or disciplinary action against her as a midwife? If so, what was the circumstance and outcome?
•Does she do water birth?
This is all I can think of for now. I think it’s a long enough list

I don’t think that most of these questions have right or wrong answers particularly, they will just shed light on each midwife’s philosophy about practice. I would avoid anyone who is not current in NRP and BLS. If you find someone who has had disciplinary action or an investigation, you’ll probably want to do a little more research to find out more about the situation and make sure that it was an isolated incident.

[DoulaVallere]

The pp's list was very similar to what we asked at our interviews. You might follow up the transfer question with WHO transfers...ie, our mw said that while she transfers about X% of the time, about 90% of those are first time moms who had 24hr+ labors, were exhausted, and requested drugs. So, that made me feel even more confident because I wouldn't be a first time mom and I'd already survived a 30+ hour natural birth, so to ME, her % (as it related to my situation) was really significantly lower than the number she gave me.

One other thing that I think is a pretty important question to ask is about how many prenatals and postpartum visits she does, and where she does them (if she's a long drive away, you'll be adding gas$$ to the price of her fee), and whether the postpartums include newborn care. That way you know whether you'll be wanting to immediately make an appt with the ped (if you would want to) for the baby or whether the mw will do all the newborn stuff for the first month, or what.