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how do you choose a midwife?

post #1 of 5
Thread Starter 

i feel so lost at this. i have a doctors appointment in a few weeks but i don't plan on doing a hospital birth as i did with my first. my biggest fear is getting pushed into induction when i'm not even at 42 wks and have a healthy baby growing inside that just needs a little more time. i hated the hospital, i hated getting treated like giving birth was an 'illness' and i just straight out refuse to do another induction. I didn't like being forced to push while on my back and not on my side like i was asking to and having a constant monitor on the baby that couldn't even keep track of her while in labor. there are hundreds of things i could go on about.

 

i have friends who have home birthed but i'm not really wanting to come out and tell people i'm preggo just yet. i've found a few names on MDC that keep coming up, but i also live way out there (like a 45 min drive to their office or basically anywhere from my house). i'd feel more comfortable with some one closer. any one have good website as far as what questions to ask midwifes when interviewing? how do you ask friends without really giving it away?

 

How much do you really think a dula is needed? how do you choose a dula? i'm so baffled by researching and i'm feeling kind of overwhelmed. hubby and i don't have insurance so it's all going to come out of pocket and i'm hoping to keep some $ down, but if a dula is really going to make a difference, i'm open to it, i'd just love to hear really good reasons to have one and also reasons of people who chose not too.

 

there's no cut and paste answers but i'm just wondering if any one can send over some useful info to get me started and down the right path. I'm going in circles.

post #2 of 5

Here is a great list of questions for a midwife...

 

Professional  questions:
Are you currently certified as a midwife and by what organization?
Are you licensed by the state?
Do you keep statistics of  your births and what happens at each one?
What life saving measures are you currently certified in?
Neonatal resuscitation?
CPR?
Advanced Life Support in Obstetrics (ALSO)?
Pedicatric Advanced Life Support (PALS)?
Are you a member of your state midwives organizition?
Do you participate in  formal peer review with other midwives?
Have you ever been named in a law suit? Please explain.
How many hours of continuing education do you complete each year? 
How many continuing education hours are required to keep your license or certification?
Questions about how a midwife practices:
How many births have you attended?
How many internal checks do you normally perform?
Do you have a problem using a fetalscope instead of Doppler most of the time?
If you are sick or otherwise unavailable during my labor, who will attend to me?
How many assistants do you normally bring to the birth?
Who are your usual assistants?
What is your hospital transfer rate (or, how many times have you had to go if it's low)?
Interview Questions to ask the MidwifeDoes your rate include transfers that occur during labor, or all transfers, including conditions that develop before 
labor? If it includes all of them, do you know a breakdown of before labor/during labor transfers (just trying to 
get a feel for how many moms transfer during labor)?
What is your typical transfer, one that requires intervention, or one where the mom desires it?
What is your c-section rate?
What hospitals have you transferred to? What is your favorite hospital to transfer to?
How are you treated when you transfer a client to the hospital?
Do you stay with me after the transfer and offer support for my decisions the best you can?
How familiar are you with procedures in the hospital?
If I develop a condition that makes me high risk, do you have a doctor you normally use to transfer my care to? 
Do you also try to use this doctor for transfers during labor?
What is your cut-off for considering a baby to be premature and requiring a hospital birth?
What happens if I go past 42 weeks?
What conditions make me high risk ? How would you treat these conditions before they make me high risk?
At what point would placenta previa make me high risk?
What are your normal guidelines for weight gain, or do you just stress good nutrition?
Do you deliver breech babies? What do you try to turn a breech baby?
How long are you willing to wait for a baby in a bad position to change positions before labelling the pregnancy 
high risk?
What percentage of your clients tear?
How do you work  to prevent tearing?
How many 3rd or 4th degree tears have you had? Up to what degree do you suture? How many episiotomies 
have you performed?
How long are you willing to let a client push, or do you base it solely on the baby's stress level?
Interview Questions to ask the MidwifeAre you willing to use alternative protocols for Strep B such as grapefruit seed extract?
Do you have a protocol to help prevent me from being positive for Strep B?
Do you have a problem waiting for a while after the placenta is delivered to cut the cord?
What do you use to stop excessive bleeding after delivery?
Have you had any experience with shoulder dystocia?
Have you had experience with cord prolapse?
Do you have any special things you do after a birth such as an herbal bath?
During labor, how active are you in checking the client, etc? 
If my water breaks before labor starts,  how long will you wait before trying to start labor, or transfer to the 
hospital?
What equipment do you normally bring to the birth (birthing stool? blow-up pool? oxygen? ambu-bag? pitocin 
shot?)
Under what conditions would you artificially rupture the amniotic sac?
Do you do the required newborn screening bloodtests, or will I need to see a doctor for this?
What happens with your fee if I have to transfer out of your care?
Do you file with insurance? Have you had any experience filing with _____________________________?
Do you require that I take a childbirth education class?
Have you had any bad outcomes for the baby or the mother? Please explain them.
Have you had any women or their families dissatified with their care? Please explain. How did you handle this?
What do you normally do while I am in labor?
These questions have been taken from conversations with women, their  families, and other midwives. 
Hopefully the answers you receive when asking them will provide you with insight into the midwife’s 
philosophy, personality, and professionalism.
Interview Questions to ask the Midwife
post #3 of 5

Okay so that was a huge list...I don't think I asked all of those when I interviewed mine. My midwife was an hour away.

 

Here's how I choose mine for my last birth...

I interviewed several and hadn't yet decided when I miscarried. I called each of the midwives to let them know I had lost the baby and I only had one pray with me and call me the following week to see how I was doing. I based which one I wanted at my birth by how she reacted to my loss. I certainly wasn't planning on losing the baby (duh!), but it was great in helping me decide who to pick. She was perfect for my prenatal care and birth. She told me at every appointment she believed in my body. I so needed that since I was planning an HBA3C. 

 

I would really suggest you interview quite a few and ask them how they feel about being almost an hour way from you. Feel them out...I just "knew" when I'd met mine. :)

 

--Erin

post #4 of 5
Thread Starter 

Wow Erin! that's a long list and very detailed. thanks a lot, this will be a big help! i've managed to find one midwife close by, whom i'm going to interview. i want to find about 4 or 5 to interview and go from there. i did a similar thing when finding an OB (who was almost right on to what she practiced/believed) and a pediatrician for DD (the pediatrician we chose did not turn out to be the doctor i was looking for after all).

 

now i need to file down that list and schedule some 'meet and greets'. :)

post #5 of 5

Awesome. I will definitely ask some of those. There are a few midwives in my area to choose from. I am hoping I will have that feeling of it being a clear choice when I meet them all. My first child was with an OB. I am really looking forward to not going through that again!

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