Questions to ask potential midwife?

[nstewart]

I'm not sure if this is the best forum to post this question, but since we are choosing a midwife in part because we'd like a homebirth this time around, I thought I'd give it a go.

Does anyone have a good list of questions or a good resource for "interview" type questions for a potential midwife?  From the birth centre's website I have a good idea of the background and training of each midwife in the cooperative, but I am unsure about what to ask specifically, besides a few basic things.

I am planning on asking about:

- when a hospital transfer would take place

- when a homebirth would/would not be an option

- protocol in case of emergency (even here the only thing I can think of to ask is whether or not she carries picotin)

- frequency of appointments/what to expect at appointments

I admit to being poorly informed.  We had care from a low risk clinic last time (all MDs, no obstetricians) and a hospital birth last time so this is a new area for me.  I am currently reading "Birth Matters", have also checked out "Mindful Birth" from the library, and plan on re-reading "Gentle Birth, Gentle Mothering" but am obviously in need of resources.

Thanks!

[IdentityCrisisMama]

I had two planned HBs (one transfer and one HB). I'm big on the general vibe you get from your MW so I think it's important to leave room to chat and get a feeling for your overall fit. That said, there are some things I'd want to know: 

• What are your transfer rates
• What is the transfer climate like in your city when HB clients arrive in the hospital 
• What sort of client care options are available to you (pitosin, yes, and whether she can use an IV)  
• I would want to know about the back-up care situation 
• I would want to talk about post-natal care and outcomes 
• I would want to know how she handles the various testing issues that may deviate from standard care at an OB's office 
• Number of births as an independent MW 

[birthlink]

The best book ever on home birth is Ina Mae Gaskin's Guide to Childbirth. She has a great list of questions along with lots of other great information. This is the one book to read. Interview more than one midwife. I suggest three. The home birth ones are available to talk on the phone. You can get a sense of who they are as a person from one conversation. Then interview in person. It also helps to understand the political climate in your state regarding home birth. Best birth wishes - Jo Anne

[bioshannon]

Hi- congratulations on your upcoming homebirth!  Besides the fantastic book that Jo Anne just recommended, one of my favorite reads is Henci Goer's "The Thinking Woman's Guide to a Better Birth."  Also, hire a doula!  My own doula was invaluable in my (successful) goal to have a VBAC (vaginal birth after cesarean.) Best of luck.

Shannon

[nstewart]

Thanks everyone!  I am taking notes!

I am very lucky to be in a province in Canada where midwifery care is viewed essentially as being the same as low risk care from a MD.  The norm here is for obstetricians to only be used in the event of high risk births and midwives are covered by public health insurance and equal access to any requested/required testing and to hospitals if a hospital birth is necessary.

I look forward to reading the books mentioned above.  I also did have a wonderful doula when DS was born, and hope to have her at the birth of this little bean as well.

Thanks again!  I'm very excited to do some reading and learning.

[Turquesa]

Are you using a doula? If so, you might feel out her attitudes toward doulas, her experience with clients who use doulas, etc. You can sometimes get indirect answers to these questions by asking, "Are there any doulas that you've worked with that you'd especially recommend?"

[ahdancesing]

Other questions I asked (in addition to the aforementioned):

*How is care handled for the baby after birth (in the days following)?  (Do they come to your house or do you need to schedule something w a ped after the birth?)

*What types of births concern her? (ie some MWs are fine w shoulder dystocia, some aren't)

*How many MWs will be at the birth?  (My hb MW group always takes 2 to a birth which was imp to me in case the birth took a long time or there was a problem)

*What items does she bring to the birth? (ie my MW brought oxygen for both mama & baby just in case)

*What hospital does she transfer to & what is her relationship with that hospital?  AND If something does go wrong, what is the process for checking one of her hb mamas at the hospital?

*At what point during the pregnancy, and then the birth, would she know if something is wrong?

*What were the reasons they have transferred in the past?

*Have there been any deaths of a mother or a baby?

*How long (days) after the birth do they care for mama?

*Do they clean up the birth area and how much cleaning do they do?

*What items do they require that you provide (ie food, drinks, etc)

*Do they test for strep?

*What care will you need outside of the MW's care?

*How do they handle the record transfer with your provider you see after birth (ie for yearly paps or whatever else)?  (ie do they take care of the transfer immediately or do you need to initiate anything)

What an exciting time.  A hb is an incredible, amazing experience!!!

[alaskanmomma]

How many maternal/baby deaths have they had? WHY if they have?
Transfer rate, do they usually transfer due to emergencies or just mama being tired, wanting to go, etc.
Are they trained in infant CPR?
What are you expected to buy..birth kit, meals for the midwives while they are there, etc.
Do they have hospital privileges? If not, what do they do if you transfer? Do they take on the role of a doula? 
Discounts if you pay before a certain time frame(granted you are paying out of pocket...)

[eabbmom]

I would ask for references from a momma that transferred care, one that was pleased with her birth experience and one momma that may have had trouble (long labor, birth trauma)- I would hope to get a varied supply of references to see how your midwife handles different situations. Not all mothers will be happy with the same midwife and it is good to hear from the ones that didn't have the glowing hb experience with your mw. A mw may not be forthcoming with those references but hopefully she would.

I know that I would give a fair reference to my midwives now that I am away from the trauma and worked through it.

[BubbleMa]

I had a whole list of questions to ask, and they ended up covering most of them themselves.  I did ask some "what would you do if..." type questions.  I had done my research, and knew what I wanted them to say so it was reassuring to hear the "correct" answers.  :)