Friday, March 22, 2013


44 Questions For Your Midwife

by SVEA BOYDA-VIKANDER on JANUARY 1, 2013
Written by Svea
Just last week I had the privilege of meeting with two fantastic midwives. Recommended by a friend, they are the women I hope will accompany me through my second pregnancy and delivery. They are kind, empathetic, knowledgeable, and funny. Exciting!
When I told my husband the news, he had a lot of questions. Most of them (“How much does it cost?” and “Do they know what they’re doing?”) I could answer. But some, I couldn’t. Hubby wanted to know exactly what they would do in an emergency – “Tell me about a time when things didn’t go well. What did you do?” and, “Have you ever lost a baby? Why?”
I got all defensive and said that well, I had asked the questions thought were important, and I’m pretty informed about birth and doesn’t he respect anything to do with intuition? Then I got mad and started defending the scientific realities of emotional support (emotionally supported births are not just happier, they’re healthier!) and he said something about how he’s always the one asking the hard questions and it turned into a whole late night conversation that, I guess, we’d been needing to have for a while.
But anyway, I thought I’d share some of the questions I asked in the interview. The query of what to ask a potential midwife used to come up a lot on the BWF support group (and probably does now on the BWF Fans group, but I’m left out because I’m not on Facebook, *sniff*); some of the items below are taken from those conversations. I personally think that ‘goodness of fit’ is the best thing to look for, but we all have to decide what that means for ourselves. The first few are the questions I asked (and the answers that made me so happy).
  1. I plan to refuse almost all vaginal checks. Like, maybe I’ll allow one. What do you think about this? (they don’t check unless the mama requests it! woot!) 
  2. Are you familiar with other ways of assessing dilation(yes, e.g. vocalization)
  3. Do you deliver breech? Do you deliver all kinds of breech? Do you have training and experience in this kind of delivery? If not, do you have a midwife you would refer me to if the baby had not turned? (No, but a neonatologist who trained under a midwife in Chile works at a hospital nearby and he does)
  4. Do you have experience with turning babies, not hospital version-style? (Yes – almost 100% success rate)
  5. At what point would I get ‘risked out’ of your practice, e.g. how many weeks ‘overdue’ could I go before you transferred my care to a doctor? (As long as baby’s healthy, as indicated by Non-Stress Tests, you can stay with us) 
  6. What do you do in the case of a nuchal cord?
  7. Speaking of cords, we intend to do delayed cord clamping. What do you think about this?
  8. How long have you been practicing midwifery?
  9. Why did you become a midwife?
  10. What is your training/education/certification?
  11. Will you deliver the baby, or will you assist me in birthing him/her/them?
  12. Do you have experience and recommendations for prenatal nutrition?
  13. Do you deliver twins?
  14. Are you connected to a natural birth/natural parenting community I could get to know?
  15. Do you do the Gestational Diabetes screening? Is there an extra cost associated with it? Do you ‘allow’ your clients to eat a specific meal before the test, or do you make them swallow a sickeningly sweet orange drink?
  16. Do you continue to see clients with Gestational Diabetes, or do you refer them to an obstetrics practice?
  17. How much do you charge, and by what date would the full amount be due?
  18. Do you accept payment plans? What is your refund policy if we decide to switch care providers?
  19. How often do your clients succeed in having their health insurance provider reimburse them?
  20. Do you work with doulas?
  21. Do you work with birth photographers?
  22. Who is your back-up pair of hands/midwifery assistant? When can I meet him/her?
  23. What is your hospital transfer rate?
  24. Do you do routine episiotomies? Do you do any episiotomies?
  25. What equipment do you bring with you to a birth? Are you legally allowed to carry Pitocin (for rare post-birth hemorrhaging)? Do you?
  26. Are you trained in neonatal resuscitation?
  27. How many births do  you take on per month/year?
  28. Are you planning any vacations, trips, major surgeries, or other events that would interfere with your attendance at the birth?
  29. I am an abuse survivor and this may affect my experience. Do you have training in counseling or other trauma-healing work?
  30. What kind of postpartum care do you offer?
  31. Do you do placenta encapsulation? Is there an extra charge?
  32. Do you facilitate water birth?
  33. What methods of pain management do you recommend?
  34. My partner has x, y, z fears about home birth. How have you dealt with this in the past?
  35. What is your preferred method of communication, prenatally (phone, email, text)?
  36. Midwifery is a challenging profession, and often a labour of love. What can I do to make this experience easiest for both of us?
  37. Have you had any loss (baby or mother)? Why and what happened?
Also, here are some questions I asked myself after the visit:
  1. Would you be friends with these people? Why/Why not? (Yes. I hope we become friends)
  2. Does either remind you of your mother? How do you feel about this? (Not much – and only in the best ways)
  3. Were you able to ask all the questions you wanted to? Why/Why not? (No – I didn’t ask about hospital transfer rate because I already felt that we’re on the same page)
  4. How did you feel about the birth when talking with them, compared to how you feel about it normally? More or less excited, more or less anxious? (More excited! Not anxious at all)
  5. Was the visit enjoyable? (I didn’t want it to end)
  6. If there were other family members present, what was their experience of the interaction? (My husband was at work but they were kind to my toddler and flexible with his needs)
  7. Did you sense that either was intimidated by your birth nerdiness and stance as an educated consumer? (Nah, we’re all passionate about birth, why would that be a problem?)
While it doesn’t make sense to ask a potential midwife all of these questions in an interview, this is also by no means an exhaustive list. You can pick and choose according to your own needs and wishes. And add your own – if you have a suggestion, please let us know in the comments and I will add it above.
*All photography in this post by NHance Photography
Posted by Birth Without Fear

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