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I'm interviewing a few homebirth midwives soon and I was wondering if you guys could look over these questions. I read the sticky on top and I made my list very thorough but I'm wondering if I'm missing anything. I'm new to homebirthing so if I'm missing something important that you experienced ladies know about please let me know!

Name:
Interview date:
Experience
1.) How, when, and where did you receive your midwifery education?

2.) Is your certification in neonatal resuscitation up to date?

3.) How many births have you attended?
4.) Do you have guidelines or restrictions about who can give birth at home?
5.) What is your definition of high risk?
6.) When do I call you during labor?
7.) Do you work alone or with a partner or assistant?

8.) If you work with someone else, how would I get to know everyone who may attend my birth?

9.) If you work with several, what happens if I don't want one of them, or prefer one of them at my birth?

10.) How often will I see this assistant during pregnancy?

11.) What exactly is the assistant's role?

12.) How many mothers are due the same time as me?

14.) Do you have a maximum number of mothers you will work with at a time/in a month?

15.) How do you manage to avoid too many commitments?

16.) What do you do if two women go into labor at the same time?

17.) What is your back-up system during pregnancy and labor-when you go on vacation, are sick or with another mother?

18.) Have you ever missed a birth? If so, what were the circumstances?

19.) What is your communications system like?

20.) Do you have a beeper or cell phone? If not, how do I reach you?

21.) Are you available 24 hours a day at all times?
22.) How do you feel about water births?
23.) Is it ok if I have my other children/family present at the birth?

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.) How soon will I be able to start my prenatal checkups?

6.) Where will my prenatal visits be held?

7.) How often will I see you?

8.) How long are the checkup appointments?

9.) What do your checkups consist of?

10.) When and where will I be having my ultrasounds?

11.) Do you do internal exams?

12.) How many women do you see at prenatals daily?

13.) What pharmaceutical drugs, homeopathics and/or herbs do you use prenatally?

14.) Do you recommend "routine" blood tests or other types of tests? If so, do you provide these tests?

15). Do you require that I see a physician during my pregnancy even if everything is all right?

16.) What are your expectations of me regarding self-care in pregnancy?

17.) What are your guidelines concerning weight gain, nutrition, prenatal vitamins, and exercise?

18.) What are your guidelines concerning the length of pregnancy? Do you allow the mother to go past 42 weeks and still have a homebirth?

19.) What are your standards for preeclampsia?

20.) Do you come to my home any time before I go into labor?

Hospital and Obstetrician

1.) What situations do you consult him/her for?

2.) Do you have a particular backup physician/hospital?

3.) Is this covered by my insurance?

4.) What problems or complications in pregnancy would mean that a physician would become my primary maternity caregiver?

5.) What arrangements would you have for my care should I develop one of these complications or problems?

6.) Would you continue to have a role in my care?

7.) What hospital would my baby be taken to, in the case of an unforeseen complication?

8.) What is the procedure for transfer?

9.) Under what circumstances do you transfer to hospital?

10.) What is your percentage of hospital transfers?

11.) What is your Cesarean rate? What are the most common reasons?

12.) What would be the plan of action if a transfer to hospital were necessary?

13.) Which hospital would we go to if I needed to be transferred?

14.) What care would you give me if I need to transfer?

15.) What are your privileges in this hospital setting?

16.) 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.) What sort of monitoring of the baby do you use during labor?

12.) How often do you listen to baby during labor?

13.) How many people are you comfortable with being present at the labor and birth?

14.) Do you encourage family participation? How? Will you allow my partner to be as active at the birth as he desires?

15.) Do I get to decide who catches my baby (myself, my husband, my child)? Where is the best place to do the pushing?

16.) How do you feel about having a doula at a homebirth?

17.) Do you wait until the cord has stopped pulsating before it gets cut?

18) . How much time do you allow for the delivery of the placenta? What is done with the placenta once its delivered?

19.) Are you comfortable with water birth?

20.) Do you allow the placenta to be delivered underwater?

21.) Do you have a tub the clients can use?

22.) What is your policy regarding episiotomies?

23.) What is you episiotomy rate?

24.) What is you rate of tears or intact perineum?

25.) What happens if my perineum needs stitching/suturing?

26.). What supplies do I need for the birth? Where can I purchase those supplies?

27.) Do you help with cleanup?

28.). How long do you stay after the birth?

29.) How would you control postpartum hemorraging?

30.) If I am 10cm dilated but don't feel the urge to push, what would your response be?

31.)How long are you willing to let a client push, or do you base it solely on the baby's stress level?

32.)Are you willing to use alternative protocols for Strep B such as grapefruit seed extract?

33.) Do you have a protocol to help prevent me from being positive for Strep B?

34.) I am RH negative, and my husband is positive. Do you administer the rhogam shot during pregnancy and after delivery? Do you carry thimerisol free rhogam shots, and if not, would you be able to obtain some?

35.) Have you had experience breaking the clavicle if it ever becomes necessary during a dystocia incident? How would you handle this situation?

36.) Have you had experience with cord prolapse? What would you do in that situation?

37.) What would you do it there was meconium in my water breakage?

38.)Under what conditions would you artificially rupture the amniotic sac?

39.) How do you handle PROM? (premature rupture of the membranes)

40.) How would you handle umbilical cord compression?

41.) How would you handle abnormal presentation?

42.) How would you handle prolonged labor?

43.) How would you handle placental abruption?

44.) Have you had any bad outcomes for the baby or the mother? Please explain them.

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 .) What is NOT included in your fee?

3.) What other costs might I incur? Lab work, prenatal testing, birth classes, extra supplies and birth kits, suturing?

4.) Can you submit your charges to my insurance company? Do you have experience with Empire Blue Shield Blue Cross?

5.) What payment arrangements do you make?

6.) Installments; before or after the birth?

7) When is payment expected?

8.). What if, for some reason, you are not available to attend my birth?

9.) What if I need to transfer to someone else for care?

The Baby

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

2.) Do you examine the baby after birth?

3.) What does this examination include?
4.) Do you give the newborn eyedrops and Vitamin K shot? Can I skip that?

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

6.) 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?
3.) How often will you visit me at my home after the birth?
4.) What do these visits include?
5.) Why are they important?
6.) How often will I visit you after the birth?
7.) What do these visits include?
8.) Why are they important?
9.) Do you examine the baby at any or all of your visits? What does the examination include?
 

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Something to consider...

All of the homebirth midwives I've interviewed have given us an "informed disclosure" to read when we were considering them. It was like 10-30 pages and bound and included answers to almost all of these questions.

I like to first ask if they are taking on clients in my due month, how many they already have in that month and how many more they will take on. This needs to be clear before we waste either of our time! Then, I like to ask for materials about their practice (usually the informed disclosure) and read through that. (Just make sure to give it back to them after you read it! I accidentally kept one from a mw we didn't use and lost it...)

So, we usually have a brief meeting to give me materials to read and then a longer consultation after. This way, I know what their standard protocols are and can ask for clarification and more information about things that they have not already addressed. Then, we can just talk and see if we connect well with one another (dp also, of course!).

When you do a full-out interview with everyone...it takes a long time and it's easy to "feel bad" when you choose one over the other. I like to know right away if they're not available (whether by their standards or mine) and if our beliefs about prenatal care and birth do not jive. I also process things better when I read them than when I just hear them.

Hope this helps! Take care and good luck!
 

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I pay attention to how well they respect my desires.

My new paid attention to my wants and needs and met them

She was willing to go out of her way to take me on so I could have my 4th hb and so I didnt have to drive 800 miles to use my old mw.
 

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Wow! THat's more than I ever thought to ask. We only interviewed one, loved her, checked her references, they all came back positive, we hired her. We did get a whole packet of stuff, but I was most concerned about transfer rates, how long it would take her to get to me (she lived in another county) and if she would be offended by my potty mouth (have actually made sailor's blush!).

You've done your homework, momma! Glad you have enough choices to be so thorough...we only have one who offers in our area, so it was her or the birthing center, 40 miles away!
 

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I've found it more useful to ask for birth stories to get a feel for a midwife. I.E. Tell me about the last time you transported, the last time you resuscitated a baby, the last birth you attended.

Definitely ask for references and when you call ask specific questions- what that woman might have loved at her birth might not be what you want at all.
 
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