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#1 of 20 Old 07-26-2006, 11:22 AM - Thread Starter
 
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I'll be interviewing potential homebirth midwives soon, and I wanted to compile a list of questions to ask. I have a few in mind, but would love some help! What should I ask?

Thanks!

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#2 of 20 Old 07-26-2006, 01:29 PM
 
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Here is my list from when I was interviewing midwives:

How, when, and where did you receive your midwifery education?
Is your certification in neonatal resuscitation up to date?
What is your rate of transport? cesarean? Episiotomies?
Do you participate in regular peer reviews?
Do you have midwife or OB backup?
How many women are due within a month of my due date?
What is your plan if someone else is in labor when I am?
What are your labor induction techniques?
Do you carry an oxygen tank to births?
What methods do you suggest to alleviate labor pains?
To what hospital do you transport if this becomes necessary? Who will go with me?
What makes a hospital transfer necessary?
How often will you make postpartum visits?
What do you do if the baby is presenting breech?
Do you give eye ointment/vitamin K shot to the baby?
What do you do if there is meconium in the water?
How would you control postpartum hemorrhaging?
References?
Would we need to have the dog and cats elsewhere? Are any possible attendants allergic?
How often do you do internal exams? Monitor baby’s heart rate?
Do you test for Group B strep? If so, how is it treated?
What is your personal style and/or procedure during labor?
How many babies have you delivered? Homebirths? Water births?
How far past the official due date will you allow me to go? What happens if I pass that point?
When during labor should I call you?
Can the cord be allowed to pulse before cutting? Can we give the baby time to breastfeed right upon birth before disturbing it to clean/weigh and so on?
If I am 10cm dilated but don’t feel the urge to push, what would your response be?
What do you do if I tear? Can you stitch me or does an MD have to?
What emergency equipment do you bring to the delivery?
Do you recommend any herbs to help with during pregnancy? Starting labor? after labor pains, both internal and external?
What do you do with the placenta?
Do you consider yourself hands-on or hands-off? Why?

Mom to DD#1 8/04, nursed 43 months, DD#2 8/06, nursed 21 months and DD#3 9/08, still nursing strong
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#3 of 20 Old 07-26-2006, 01:33 PM
 
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: I was just going to post a thread about this, as I have my first midwife interview a week from today.
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#4 of 20 Old 07-26-2006, 01:39 PM
 
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Do you have any protocols which might affect my ability to give birth at home (such as no births past 42 weeks, no breach babies, etc.)?

My due date is around ___. Are you available?


Experience

1. What is your general philosophy of care; what are your basic beliefs about pregnancy and birth?

b) How many years have you been practicing as a midwife?
b) How many of these births were in the hospital? In a birth center? At home?

10. How does your practice vary for different women?
11. Do you have guidelines or restrictions about who can give birth at home?
12 a) What is your definition of "high-risk"?

When do I call you?
d) How would you handle a hemorrhage?

13 a) Do you work alone or with a partner or assistant?
b) If you work with someone else, how would I get to know everyone who may attend my birth?
c) If you work with several, what happens if I don't want one of them, or prefer one of them at my birth?
d) How often will I see this assistant during pregnancy?
e) What exactly is the assistant's role?
14 a) How many mothers do you have due around the same time as me?
b) Do you have a maximum number of mothers you will work with at a time/in a month?
c) How do you manage to avoid too many commitments?
d) What do you do if two women go into labor at the same time?
e) What is your back-up system during pregnancy and labor—when you go on vacation, are sick or with another mother?
f) Have you ever missed a birth? If so, what were the circumstances?
15 a) What is your communications system like?
b) Do you have a beeper or cell phone? If not, how do I reach you?
c) Are you available 24 hours a day at all times?



Prenatal Care

1. What do you perceive your role to be during my pregnancy; and what are your goals for prenatal care?
2. What are your expectations of clients during pregnancy?
3. Can you recommend or will you loan to us appropriate books , videos, internet sites, etc. to help us prepare for homebirth?
4. Do you require or recommend that my husband and I take a childbirth education class or attend pregnancy discussion groups? Do you lead such a class or group; or can you refer me to one?
5 a) How soon will I be able to start my prenatal checkups?
b) Where will my prenatal visits be held?
c) How often will I see you?
d) How long are the checkup appointments?
e) What do your checkups consist of?
f) Do you do internal exams?
g) How many women do you see at prenatals daily?
6. What pharmaceutical drugs, homeopathics and/or herbs do you use prenatally?
7. Do you recommend “routine” blood tests or other types of tests? If so, do you provide these tests?
8. Do you require that I see a physician during my pregnancy even if everything is all right?
9 a) What are your expectations of me regarding self-care in pregnancy?
b) What are your guidelines concerning weight gain, nutrition, prenatal vitamins, and exercise?
10. What are your guidelines concerning the length of pregnancy? Do you allow the mother to go past 42 weeks and still have a homebirth?
11. What are your standards for preeclampsia?
12. Do you come to my home any time before I go into labor?


Hospital and Obstetrician

e) What situations do you consult him/her for?
3 a) Do you have a particular backup physician/hospital?
b) Is this covered by my insurance?
4 a) What problems or complications in pregnancy would mean that a physician would become my primary maternity caregiver?
b) What arrangements would you have for my care should I develop one of these complications or problems?
c) Would you continue to have a role in my care?
5 a) What hospital would my baby be taken to, in the case of an unforeseen complication?
b) What is the procedure for transfer?
6 a) Under what circumstances do you transfer to hospital?
b) What is your percentage of hospital transfers?
c) What is your Cesarean rate? What are the most common reasons?
e) What would be the plan of action if a transfer to hospital were necessary?
f) Which hospital would we go to if I needed to be transferred?
g) What care would you give me if I need to transfer?
h) What are your privileges in this hospital setting?
i) Would you stay with me in the hospital? In the operating room? For how long after the birth?


General Labor

1. What do you perceive your role to be during my labor?
2. What are your expectations of clients during birth?
3. How early into the labor do you come to my house? When should I call you to come?
4. What equipment and supplies do you bring to a birth? Do you bring oxygen, IV fluids, ambu-bag for baby (what is this?), resuscitation equipment, medications for hemorrhage (pitocin or methergine), suturing materials?
5. How do you handle emergencies?
6. What natural comfort techniques do you provide?
7. What pharmaceutical drugs, homeopathics and/or herbs do you use at births?
8. What is your usual approach to a labor that is progressing slowly?
9. Do you let us do whatever we want during labor? (drink water, eat food, choose positions, etc.)
10. Do you do internal exams during labor?
11 a) What sort of monitoring of the baby do you use during labor?
b) How often do you listen to baby during labor?
12 a) How many people are you comfortable with being present at the labor and birth?
b) Do you encourage family participation? How? Will you allow my partner to be as active at the birth as he desires?
c) Do I get to decide who catches my baby (myself, my husband, my child)?
e) How do you feel about having a doula at a homebirth?
13. Do you wait until the cord has stopped pulsating before it gets cut?
14. How much time do you allow for the delivery of the placenta? What is done with the placenta once its delivered?
15 a) Are you comfortable with water birth?
c) Do you allow the placenta to be delivered underwater?
d) Do you have a tub the clients can use?
16 a) What is your policy regarding episiotomies?
b) What is you episiotomy rate?
c) What is you rate of tears or intact perineum?
d) What happens if my perineum needs stitching/suturing?
17. What supplies do I need for the birth? Where can I purchase those supplies?
18. Do you help with cleanup?
19. How long do you stay after the birth?


Financial Matters

1. What are your fees and what do they include? How many prenatal visits, how many postnatal visits, how many home visits, sibling preparation, lab work, prepared childbirth classes?
2 a) What is NOT included in your fee?
b) What other costs might I incur? Lab work, prenatal testing, birth classes, extra supplies and birth kits, suturing?
3. Can you submit your charges to my insurance company?
4 a) What payment arrangements do you make?
b) Installments; before or after the birth?
c) When is payment expected?
5. What if, for some reason, you are not available to attend my birth?
6 a) What if I need to transfer to someone else for care?



The Baby

1 a) Have you ever had to resuscitate a baby?

2 a) Do you examine the baby after birth?
b) What does this examination include?

9. Do I need to bring my baby in to meet a pediatrician?

11. How do I obtain the baby’s birth certificate?


Postnatal Care

1. What do you perceive your role to be after the baby is born?
2. How often do you come to see me after I give birth?
4 a) How often will you visit me at my home after the birth?
b) What do these visits include?
c) Why are they important?
5 a) How often will I visit you after the birth?
b) What do these visits include?
c) Why are they important?
6. Do you examine the baby at any or all of your visits? What does the examination include?

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#5 of 20 Old 07-26-2006, 03:46 PM - Thread Starter
 
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Excellent! Thank you so much!

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#6 of 20 Old 07-26-2006, 04:52 PM
 
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My now midwife actually answered most questions before I even got to ask when she started talking....like her education etc....

I found it important that overall she wouldn't be all around protocoll like OBs are, so to know how much overdue she'd "let"
me go and what tests she requires were important to know.
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#7 of 20 Old 07-27-2006, 05:23 PM
 
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I interviewed about a dozen mw's before ds was born. I found that some sang the praises of natural home birth, but the hard facts were that they had transfer rates of up to 50%. I was quickly able to shorten the interviews by beginning with questions about transfer rate (get the actual % or an approximate!) and reasons for transfer. Some transferred women for reasons that I would not have wanted to transfer for. If you anticipate any particular issue arising, definitely ask how they would handle it. (In my case, I expected to go quite overdue based on fam history.) This may help you quickly eliminate some mws who won't be a good match for you.
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#8 of 20 Old 07-27-2006, 05:44 PM
 
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Quote:
Originally Posted by staceyshoe
I interviewed about a dozen mw's before ds was born. I found that some sang the praises of natural home birth, but the hard facts were that they had transfer rates of up to 50%.
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#9 of 20 Old 07-28-2006, 01:02 AM
 
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i only got to interview one midwife. My DH liked her right off and wanted to hire her before she was off of our property I asked most of the above questions. She answeed many before I asked. I was very interested in her philophies about pregnancy and birth and I asked how many stillbirths she had attended and what she had done during/after them. I don't think I asked anything that was not on one of those lists up there. I also found it nice that had I not been able to work with her, she was very happy to recommend other people and encouraged speaking to others. Happy interviewing!

Namaste, Tara
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#10 of 20 Old 11-03-2006, 06:15 PM
 
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WOW, I just got some excellent information from this thread. Thanks for posting everyone
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#11 of 20 Old 12-03-2006, 11:58 AM
 
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This is a GREAT thread!
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#12 of 20 Old 12-03-2006, 12:28 PM
 
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Quote:
Originally Posted by staceyshoe View Post
I interviewed about a dozen mw's before ds was born. I found that some sang the praises of natural home birth, but the hard facts were that they had transfer rates of up to 50%.
We had a BAD YEAR once as a student when the practice had a 50% transfer rate. Was that bad? Sure if you just look at the number alone. But it was good if you looked at why: newborn with respiratory distress due to meconium aspiration syndrom; newborn with meconium plug syndrome; newborn with diaphragmatic hernia; newborn with metabolic syndrome; fetal arrythmia; mom with hemorrhage; mom with random uterine infection; a couple of moms with protracted labors and our bag of tricks was empty, and other randomly uncommon things.

So if you see a number like 50% don't assume the midwife sucks, ask why her rate is high and give some examples. You might find you are impressed with her ability to evaluate a situation and transfer appropriately.
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#13 of 20 Old 12-03-2006, 02:06 PM
 
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There's a sticky about this at the top of the homebirthing forum.
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#14 of 20 Old 12-03-2006, 04:31 PM
 
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I interviewed one MW during my pg with dd2, I had a good list of questions, and she answered them the way I wanted to so I hired her. During my pg, things started changing: so I went to talk with another MW. This time I just went in and instead of asking her question after question, I asked her to tell me about herself and her practice. It worked great, she started talking about an hour later, I hired her, I got so much more info that way then asking numerous direct questions.

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#15 of 20 Old 12-03-2006, 04:42 PM
 
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Quote:
Originally Posted by Peony View Post
I interviewed one MW during my pg with dd2, I had a good list of questions, and she answered them the way I wanted to so I hired her. During my pg, things started changing: so I went to talk with another MW. This time I just went in and instead of asking her question after question, I asked her to tell me about herself and her practice. It worked great, she started talking about an hour later, I hired her, I got so much more info that way then asking numerous direct questions.
I sort of did this. I had a list of questions that I definitely wanted the answers to, but I got more info from just asking open ended questions like "What is your philosophy on birth?" Next time around (since I will be in another state and won't be able to use the same mw), I think I will jot down a few things that are very important to me so I don't forget, but other than that, just ask general questions and let the mw talk.
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#16 of 20 Old 03-08-2007, 01:46 PM
 
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Sub!
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#17 of 20 Old 03-08-2007, 01:55 PM
 
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Thanks for starting this thread. I am about to start interviewing homebirth midwives in the next couple of weeks.
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#18 of 20 Old 03-08-2007, 02:43 PM
 
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Quote:
Originally Posted by SusannahM View Post
There's a sticky about this at the top of the homebirthing forum.

yep, here it is: http://mothering.com/discussions/sho...d.php?t=507722
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#19 of 20 Old 03-08-2007, 06:50 PM
 
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If midwives have been practicing any length of time they know the answers mom wants to hear. Doctors are the same way. If mom says she has a list of questions, he/she will pretty well know what those questions are and what the answers should be.

Letting the midwife talk, as you did, may get you a more truthful answer than the usual list of questions. That was a really good idea!

Quote:
Originally Posted by Peony View Post
I interviewed one MW during my pg with dd2, I had a good list of questions, and she answered them the way I wanted to so I hired her. During my pg, things started changing: so I went to talk with another MW. This time I just went in and instead of asking her question after question, I asked her to tell me about herself and her practice. It worked great, she started talking about an hour later, I hired her, I got so much more info that way then asking numerous direct questions.

Wife, mother, midwife, triathlete
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#20 of 20 Old 03-08-2007, 07:37 PM
 
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One thing I haven't seen anyone else say, but ask if the MW has any printed material she can leave with you. I didn't ask for it, but before my MWs left my interview, they handed me a copy of their consent form, their payment contract, their philosophy statement (which included their practice guidelines, their journeys to midwifery, and their statistics), and the BMJ study that showed that HBs were safer for low-risk women. Going over this documentation after the interview helped me to refresh my memory on what these midwives were all about, and gave DH and his family some more information since they are not as familiar with what homebirth is and what it entails as me and my family.

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