Minimum # of deliveries you'd be comfortable with

[PaisleyStar]

What is the minimum amount of deliveries would you want your MW to have attended? What's normal? 50? 100? 500?

Also how many years, minimum, would you prefer she'd been practicing before you hired her?

((I am interviewing HB midwives for our HBAC in the fall.))

Help! I am so new to this and don't know anyone IRL who's had a homebirth midwife.

Oh, also, does it matter if they've attended VBACs before or not?? One I spoke to just hasn't, because I guess women just aren't doing it in my area?
I might cross-post this in birth professionals, but I'd LOVE your opinions!

[lyttlewon]

I don't know. My midwife has 30 years of nursing, 27 years childbirth education, has attended 700 births and midwifed as primary for 400 births. I was comfortable with that.

As far as the VBAC question my midwife said that is her primary clientele since the OB's in our area are adverse to VBAC. She said even when she does a hospital transfer a few doctors will allow her to do the delivery.

[Doula Gina]

I think there are benefits to new or very experienced midwives. The passion and zeal a new midwife brings to the birth is refreshing. And because she has learned recently, she is probably less set in her ways and open to new ideas. An experienced midwife can be what some women need - like more of a mother figure, someone who is very calm and seasoned - someone who has seen it all, done it all.

I think personality is probably the most important thing for most people. Someone you feel very comfortable with, whom you trust, and with whom you can see yourself developing a very close, albeit temporary relationship.

[mamaverdi]

I'd say if UPS felt comfortable hiring her, then I'm okay with her delivering packages to my door. The weight requirements might be pretty hard on her back though.

[MsBlack]

To me, number of 'births assisted' (not deliveries--only the moms deliver) is not as important as the currency of her knowledge, her awareness of her limits (and what refs or backup she has, to help w/those limits) and her attitude (as that fits you). That said, for a VBAC I'd want someone who'd assisted at least 50, if not far more births. And I'd want to know that she was current in her understanding of VBAC, and had a lot of trust in you and in birth, without being stupid or careless about risks. Someone who strikes a balance between awareness of risks and comfortable with her trust in birth.

Another thing to consider is not just 'how many' births, but 'how many in what timeframe'. Someone can get a lot of experiences fast if they go to one of the training birth houses around the world...but someone else, who has slowly accumulated same or even fewer number of experiences, has had a lot more time to really think about, study, and integrate those experiences (well IF she is the type who will think about them).

Finally, more than numbers, I would want to know about a midwife's support community with other mws and even med. people (official or unofficial backup)...and whether or not she does continuing ed, 'peer review' in some form and has accountability w/her practice. I do not live close enough to other mws to do 'formal' peer review, for instance, but I talk about births a LOT with other mws by phone and internet--some of this reviewing is w/mws who know me personally, some is done via mw forums (less effective in some ways, still helpful). I know a mw who has done nearly 500 births and this seems really great to many people--but very scary stories come out of her practice pretty regularly, and those of us who know her can tell you that she does NO continuing ed, has never been cert'ed in Neonatal Resusc. or CPR, does NO peer review, and will NOT speak to any other mw freely about her practice, will hear no questioning or feedback from either her own clients or from other mws.

I don't care how many births a mw has done--if she is practicing in ignorance and without accountability to standards and to people, then she is dangerous. She may even be a great mw in many ways--but I'm thinking that nobody is so good that they need no cont. ed, no peer review, no accountability.

So, you can see with this that I am saying it's not just numbers that count. Ask questions, and make sure the answers are frankly and comfortably answered by the candidates you speak to.

best in finding your own best midwife!

[PaisleyStar]

Ok, I'm back with more questions. Why is the number of VBACs attended important? If they're trained to know the signs of danger. Wouldn't you rather have someone who would be aware of the risks as they are, but who would treat your birth as NORMAL than someone who, while experienced in VBAC, was treating you specifically AS a VBACer rather than just as a woman birthing a child, a natural event??
If I don't get any replies to this Q, I'll be sneaky and start a new thread about it. I'm honestly wondering.

[alegna]

Originally Posted by mamaverdi

I'd say if UPS felt comfortable hiring her, then I'm okay with her delivering packages to my door. The weight requirements might be pretty hard on her back though.

:

I wouldn't hire a midwife who claimed she did ANY "deliveries"

-Angela

[alegna]

Originally Posted by PaisleyStar

Ok, I'm back with more questions. Why is the number of VBACs attended important? If they're trained to know the signs of danger. Wouldn't you rather have someone who would be aware of the risks as they are, but who would treat your birth as NORMAL than someone who, while experienced in VBAC, was treating you specifically AS a VBACer rather than just as a woman birthing a child, a natural event??
If I don't get any replies to this Q, I'll be sneaky and start a new thread about it. I'm honestly wondering.

I'm more interested in IF she will take VBACs. IF there are things she's scared of etc.

-Angela

[jessitron]

It would depend on my own confidence level. As a first-time mom, I'd want a midwife with hundreds of deliveries. As a second time mom, I might be comfortable with someone less experienced. But like a pp said, the feeling you get from her and whether you connect with her is even more important.

[supermuma]

I think it would depend...on how you felt about the midwife.

Personally, I have felt much more comfortable with midwives who have been practicing for longer and done more births. The midwife I had for my first two had done several hundred births and had been practicing for many years.

She is now retired

I have had two midwives with this pregnancy, the first one had only been practicing for about a year or 2--at least since actually being out of training...and somehow for me it showed..and it bugged me. (among other personal-personality issues...)

The midwife that I switched to has been practicing for 27 years and has been to births well into the hundreds.

Personally, I think I would want a midwife who had attended VBACs if that is what I was having...but that is just me. I really want a midwife who has experienced a whole realm of isses in her work though!

You need to figure out what feels right to you. Another midwife without much experience might have been just fine for me...it would just depend on my feeling combined with experience.

[mothragirl]

my MW hasn't been practicing on her own for a super long time, but i like her and feel like she'll do what i need her to do during my pregnancy and birth.

[Snowdrift]

Now that I have had one birth go fine, I'd be much more comfortable with someone with a small number of births, as long as she was a good midwife--calm, non-intrusive, and non-panicky. Heck, I'd be cool with a really good doula, since I'd just as soon UC but want physical help with massage and other physical assistance that I'm not confident in DH providing.

So for me, she would have to have enough births to be relaxed. If she's a really mellow and calm/calming person, I'd be happy to be her first birth as a primary. Everyone's gotta start somewhere, might as well be with me

[GalateaDunkel]

The HB midwife I had before I transferred and got sectioned had over two THOUSAND. She was very unhelpful to me and I think it was because of cultural differences. My whole pregnancy I had a strong vibe that she was silently judging me for not being as conservative a Christian as she was, but I ignored my feelings because she was the only midwife in the area, plus, hey - two THOUSAND, what could go wrong?! When I came home from the hospital I found that she had left religious literature about 'proper womanly behavior' on my bedside table. : Oh yeah, and the nurse at the hospital (who'd been working there 25 years) said "you know, I'd never met her before you came in" and I said "wow, I'm her first transfer EVER?!" and the nurse said "oh no, she's had plenty of transfers. you were just the first one I've actually seen bring her along when they came."

Don't go by number of births.

[pinksprklybarefoot]

Originally Posted by GalateaDunkel

"wow, I'm her first transfer EVER?!" and the nurse said "oh no, she's had plenty of transfers. you were just the first one I've actually seen bring her along when they came."

As long as the mw has some experience, I would say that the "gut" feeling you get from her is the most important.

[MsBlack]

Paisleystar--

Your question about VBAC is somewhat confusing for me.

But I will say this:

If you had a systemic yeast infection, I would treat you as a person with a systemic yeast infection.

If you had had a pregnancy loss that was still an issue, I would treat you as someone with a loss to deal with during this pregnancy and birth.

If you had twins, I would treat you as a twin mom.

If you were seriously overweight....

or underweight...

or a sexual abuse survivor...

or a single mom...

or married/partnered mom...

or someone who loved medical intervention....

or who hated medicine altogether...

or whatever your unique circumstances were, I would treat you in accordance with those unique circumstances, for your own and baby's best health and good birth.

On the one hand, I can see where you wouldn't want to be treated with fear surrounding the fact of your prior csec, and you do want to be given the greatest possible consideration of normalcy. Yet I have to say that while I don't consider VBAC generally to be a cause for excessive fear leading to excessive control factors for a VBAC mom....she is still a VBAC mom (at least, for her 1st VBAC). I would have to treat you as a VBAC, as would be only fitting for your unique circumstances. That would make a difference in some ways, in how I would approach you/your situation.

I don't want my VBAC moms/dads to be scared--I DO want them to be aware and prepared. I don't want to be scared--but aware and prepared. Unexpected turns of events can happen at any birth--uterine rupture is just very very extremely rare for most moms except VBACS. Even for VBACs it's pretty darn uncommon, if there is no interference and otherwise good health. Still--this is one of the possibilities we will be on the alert for, more so than for moms with no prior uterine surgery. That is different than for other moms....it is part of what makes you unique, and part of what would guide my care choices as your midwife.

Don't know if I've answered your question, but here are my thoughts!