This is my list I came up with after gathering questions from all sorts of sources (seen end of list). In my phone interviews, I only asked a few questions:
1) How much homebirth and emergency experiences have you had?
2) Are you available around October 14?
3) Do you consider yourself to be hands-off during labor and birth?
4) 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.)?
5) Do you have water birth experience?
The phone interviews were to get a feel for the personality of the midwife, and to see if their voice wasn't annoying (seriously, must be mature, lower, calming voice--no valley girls please.).
I ended up only interviewing one midwife in person. I requested references as this particular midwife isn't well-known in my community (but has been a doula for a long time, which is a plus to me); I am still in the process of talking to all the references (3) before I officially hire the midwife.
The list below is really anal, I guess. But it helped *me* get a grasp on the details of homebirth, what to consider, etc. And, yes, in my discussion with my midwife, most of these questions were answered without my asking; or some of the questions didn't matter to me or didn't apply (I didn't want a licensed midwife, and didn't care if she went to peer group meetings, etc.)
Please let me know if you notice any typos or if I missed anything. Thanks.
Here are the five most important things my family is looking for in our homebirth:
What should I ask myself about the experience of meeting with a maternity caregiver?
+ When you go to interview a caregiver and during your prenatal visits, ask yourself how you feel about the experience:
+ Is this person listening to me and respectful of my wish to make careful decisions?
+ Is the person willing to take the time to answer my questions to my satisfaction?
+ Does this person share my vision for my maternity care and birth?
+ Do I think that I can feel comfortable with and trust this person?
+ Can I get what I want from this person?
+ Does this feel right for me?
This person will be working intimately with you and your family through one of the most important times of your life. Follow your instincts. Only you can make the decision that is right for you. If you have concerns, even if you are well into your pregnancy and prenatal care, it may be important to explore other options
My due date is around ___. Are you available?
1. What is your general philosophy of care; what are your basic beliefs about pregnancy and birth?
2 a) Are you a mother yourself? How old are your children now?
b) How were your babies born?
3. Why did you become a midwife?
4 a) How long have you been involved in birth?
b) How many years have you been practicing as a midwife?
5 a) How many births have you attended as the primary caregiver?
b) How many of these births were in the hospital? In a birth center? At home?
7. How many births do you attend in a year?
8 a) What is your education and training as a midwife?
b) Where did you train and when (in a home or hospital setting)?
c) Are you licensed or certified? By what organization? Why or why not? What are the pros and cons of being and not being licensed?
d) Do you take refresher courses and extra skills courses?
e) Have you had any long periods away from practice? If so, what did you do to update your skills and knowledge?
9. Do you participate in a local midwife peer review group? What is the purpose of these meetings? How many meetings have you attended in the past year?
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"?
b) What is your policy regarding high-risk pregnancies: breech or transverse lie babies, twins, mother over age 35, high blood pressure, diabetes, fetal distress, toxemia, VBAC?
c) If you do attend births with these types of situations at home, what is your experience with each of these?
d) How would you handle a hemorrhage?
e) What extra back up is provided for these high-risk situations?
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?
16. Will you give me the contact numbers for some of your recent clients?
17. Will you give me the contact numbers for any other midwives to interview?
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
1. Do you attend births in a birthing center or hospital?
2 a) Do you refer to or work closely with any doctors?
c) If you do, who are they?
d) Do I need to see him/her prenatally?
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?
c) If not, can you work with a physician/hospital under my insurance plan?
d) Do you have pediatric backup?
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?
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?
c) I want the use of a fetoscope, but not a Doppler. How do you feel about this?
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)?
d) What suggestions do you have regarding siblings being present?
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?
b) How many home water births have you attended?
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?
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?
d) Do you accept alternative methods of payment, such as sliding scale, time payments, or barter?
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?
b) How much does your backup physician charge?
c) What are basic hospital charges?
1 a) Have you ever had to resuscitate a baby?
b) Have you ever lost a baby under your care? What were the circumstances?
2 a) Do you examine the baby after birth?
b) What does this examination include?
c) Does it include Apgar assessment, evaluating my baby's heart rate, breathing, muscle tone, reflex response, and color?
3. Do you give antibiotic ointment eye drops to the baby?
4. Do you recommend giving oral Vitamin K to help baby's blood clot; if so, do you carry it yourself?
5. Do you recommend newborn hearing tests? Is this done only in a hospital?
6. Do you recommend a PKA blood test? Is this done only in a hospital? [Heel is pricked and a small amount of blood taken to test for phenylketonuria (PKU), hypothyroidism, and other disorders.]
7. Will you help me with breastfeeding?
8. How do you feel about circumcision and immunizations?
9. Do I need to bring my baby in to meet a pediatrician?
10. Do you have a pediatrician you work with or recommend?
11. How do I obtain the baby's birth certificate?
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. Do you provide or know of anyone who will help new mothers after 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?
Heart and Hands : a Midwife's Guide to Pregnancy and Birth