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Need a list of homebirth midwife interview questions

589 views 11 replies 9 participants last post by  tribord 
#1 ·
Hi everyone, I am 30+ weeks pregnant and may have to give up my dream of a birth center birth and find a homebirth midwife. I recently failed the 3hr GTT and even though I am a slim, healthy 32 year old whose weight gain has been perfect and the baby is measuring perfect and I exercise everyday and eat a whole foods, homemade organic diet - the birth center will not allow me to deliver there unless I stick myself four times a day for 2 weeks and pass their criteria (i.e. give them the right numbers for their files.) If not, my only choice would be to transfer to a hospital birth where they will want to medicate me for the remainder of the pregnancy and do weekly sonograms. All of which, of course, will end up in a hospital birth where the baby's glucose will be tested every hr for 24hrs after birth.

I never thought about having a homebirth and now feel really overwhelmed that I may need to find a midwife. I do have the contact information for one woman who has worked with two of my friends previously and comes highly recommended. I just don't even know what to ask her to feel prepared and comfortable to do this at home.

Any links to lists of interview questions or your own experiences would be greatly appreciated. Thank you!
 
#2 ·
Gestational diabetes does not happen because you are obese... yes it is more likely to cause excessive weight gain during pregnancy, but that is not always the case either.

I have gestational diabetes in my family... Ive never had it, but two of my aunts did and my mom was always borderline for it... one of the two aunts was obese, the other was nearly underweight.

I think, having failed the 3 hour test it would probably be best for you to do the sticking yourself daily for a couple weeks just to rule out diabetes. Because while you may not think you have it... you could... and it really could just be better for baby to know that for sure.

For the most part, if you do not qualify for a birth center birth... no homebirth midwife will touch you. You are too much of a risk for birth center, you are way too much of a risk for a homebirth.
 
#3 ·
Quote:

Originally Posted by lolliegee View Post
Hey All, I was just reading this very interesting blog article today on just this subject. It talks about the whole GD thing is pretty bogus. I wish I had known some of this stuff with my 2nd child, I probably wouldn't have ended up on insulin and a very medicalized, induced using scare tactics hospital birth.

http://www.drmomma.org/2010/06/gesta...or-has-no.html
Got this from our GD test forum, and I just wanted to give it to you to read through. Maybe you can talk to another hcp, if you are not experiencing any of the symptoms of GD maybe you were just more sensitive to the sugars and carbs in the tests you were given. This can happen (I have heard) if the woman taking the test is not used to imbibing complex sugars and carbs. I can understand your concern, and do not know what I would do in your situation, but just as MP said you may have no chance of finding a birth center or a practicing mw willing to take the responsibility of your birth, unless you can somehow resolve the negative test results.

If you can find a practicing and licensed mw willing to assist you in a hb, I did find this comprehensive questionaire that seems to cover most of the questions that are necessary when looking for a hbmw


My thoughts are with you and you LO! Please keep updating.
 
#4 ·
I don't have a list of questions for you as I'm planning a birth center birth, but do have a few thoughts.

1. Before you make a decision, can you test your glucose at home for a few days to see what your numbers look like? I'm learning that a lot of people have meters lying around and usually have some extra sticks and lancets, too. I agree with Maeryn that you should probably test your glucose for a while regardless of what your providers want just to make sure that everything looks OK. If your numbers look good (and find out what the birth center wants/needs your numbers to be as different providers have different criteria), you may want to chance sticking to the birth center. I failed the one-hour test with a level of 147 and have been monitoring my blood sugar at home since then. It has been totally normal/low. If you do not normally eat a diet with lots of carbs, you may have gotten falsely high numbers on your 1-hour and 3-hour tests.

2. There was a lady in my hypnobabies class who risked out of a birth center birth (although she didn't go into detail why, but she had been seen there for years for her well-woman exams and always told that if she was pregnant she could not deliver there). She is having a homebirth, so it isn't automatic that a HB midwife wouldn't take you. Definately worth looking into.

Good luck, and keep us updated!
 
#5 ·
I don't have a lot to add.....when I was talking to my midwives about the GD screen and whether or not to do it, she mentioned that the only baby she's ever lost was due to a GD complication. She emphasized that some people don't fit the typical criteria and still have it, and that it's no joke. So if it were me, I'd do whatever it takes to determine if I had GD or not - even if that means a bazillion finger pokes.

If you decide to go the HB route for sure, I would use similar questions to what you use to choose a birth center midwife. As long as you feel she is competent, carries all the necessary equipment, and you like her, go for it.
 
#7 ·
My sympathies on your test results, AaronsMommy. I won't weigh in on my personal feelings about GD because I could go into a rampage. I will say though that the article that BabyBraatensMama shared is an excellent one with a more balanced look at the hysteria that I think surrounds the GTT and GD. Henci Goer, the author of the article, also wrote "The Thinking Woman's Guide to a Better Birth." I read it several months ago (wonderful book!), but I do recall that she had a list of questions to ask of your care provider in it.

I hope that despite complications you may be facing now that you are able to have the kind of birth you want! From talking to women who have had MWs at both birth center and homebirth, the overwhelming majority said that they were SO thrilled with being at home!

Just from my experience, things I *wish* I had asked...
  • How many births do you schedule in a month? Do you turn clients away when you have reached a certain maximum? What is the likelihood that you will NOT be at my birth due to a large clientele?
  • If not a CNM, does she have a nurse or doctor that she can consult with about any complications?
  • How many births have you attended as the primary care giver? How many years of experience do you have? (I did ask this, but my options were so minimal, I didn't weigh it as heavily as I should have.)
 
#8 ·
I am in Maryland as well and planning a homebirth. I can give you some contact information regarding homebirth midwives in the area, although they tend to fill up kind of quickly.

I don't think becasue GD risked you out of birth center, our HB MWs will necessarily risk you out. I think it would be great to talk to some HB MWs and see what their take is on the birth centers risking out.

Are you with SB or BAM, or into DC? I've heard that SB has become more more 'medical minded' over the last few years risking people out and AAMC is not really the best hospital to deliver at, which is where their backups are.

Anyway, send me a PM or post in our tribe and you will get lots of good information about your options in Maryland.
 
#9 ·
I don't have the book in front of me since I had borrowed it, but I remember the book She Births had a great list of questions, maybe you could order it on amazon or find it at the library!
 
#10 ·
OP here - thanks for all your support ladies, it truly helps! I have decided to hold off interviewing midwives for 2 weeks while I keep a food log and check my glucose 4x's per day. I really don't believe in GD, per se, and I don't think there is anything about my health or the health of the baby to worry about. So, if the numbers make everybody happy, I would still deliver at the birth center (I am at the Birth Center in Wilmington, DE - I live in Northern MD.) Next time, it is homebirth all the way! I certainly learned my lesson. I had some unrealistic expectations about the birth center experience. But, it is better than a hospital birth and this has been a very stressful pregnancy for me already, and it would be much more stressful to have to switch mindsets to finding a midwife, planning a homebirth and figuring out how to pay for it.

Once I get past this hurdle, I have to figure out how to naturally test negative for GBS, since I will refuse the antibiotics at birth either way.

Thanks again ladies
 
#11 ·
When I was pg with dd I converted my +GBS to a GBS- from 35 to 37 wks. It can be done


The midwife then told me "once a + always treated as a +" but I argued her down and we did a modified agreement for what the abx protocol would be.

With ds, I tested - (used the same protocol that I did with dd to convert) and it was a non-issue. This time my mw lets me do my own swab, so I could just fake it too. abx at home aren't going to happen, so it's just a matter of being aware/alert to early infection signs and acting promptly.
 
#12 ·
Quote:

Originally Posted by LEAW View Post
When I was pg with dd I converted my +GBS to a GBS- from 35 to 37 wks. It can be done


The midwife then told me "once a + always treated as a +"
Same here... converted my positive at 34 weeks to a negative at 37 weeks, having been told by one midwife it meant I wouldn't need abx. Then the head midwife told me the second test was a waste of time b/c I would still need abx ("once a + always a +"). I just went along with it b/c I felt pressured and didn't really know much about it. There was only time for one dose, though.

They want to retest me again this pregnancy, and I'm hearing different things from the different midwives in the practice as to whether they will recommend treatment if I test negative. Regardless, this time I'm planning to refuse abx unless my water has been broken for a really long time or unless the baby is premature, and maybe still refuse even then. But it would still be nice to have a recent negative test in my chart to help back me up a bit.

AaronsMommy- congrats on reaching a decision about the GD. I have found testing my blood sugar to be really interesting. I agree with you about the birth center experience this time. Although I didn't really have those feelings with my last pregnancy (having switched from an OB/hospital plan during my late 2nd trimester the birth center seemed like heaven at the time) this time I find myself thinking a lot, "wow, maybe I should have done a home birth".
 
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