How to choose your midwife:
10 questions to ask your midwife and some practical advice
Choosing a midwife is very challenging decision. It is also very important! The life of both you and your baby rests in your midwife’s hands. The questions that follow will help you find a midwife who has the necessary skills and qualifications. We say “there is a midwife for every mother.” What is most important for you in terms of the specific skill set your midwife brings into the birthing room? Tailor your questions to reflect your priorities. Interview at least three different midwifes. Your partner’s sense of safety and resonance with a midwife is also paramount. Take notes as you chat with your potential midwives to be able to refer back to in the future; after a few interviews their different responses can become fuzzy in your mind.
1. How skilled are you at suturing? How often have you sutured in the last year/last 5 years? What sorts of things do you do to prevent tears from occurring?
Having a bad tear at the time of the birth can cause the healing process to be much longer. In the worst case scenario poor suturing or lack thereof can lead to chronic pain, pelvic floor prolapse, incontinence and diminished sexual pleasure. Unfortunately these sequelae are far more common than most people realize. Women, silenced by shame, often don’t speak up about the pain, inconvenience or lack of pleasure that they experience as a result of inadequate perineal care at the time of their birth.
2. Do you carry and use IVs? How comfortable are you placing them? How often do you use them?
Using IVs can be an important part of treating a hemorrhage or reviving a tired, dehydrated mother in labor. Being able to place an IV correctly can prevent an unnecessary transport to the hospital. Assessing your midwife’s comfort with IV’s can be challenging as a lay person. Don’t be afraid to press a little in the interview to get a clear picture of whether your midwife is prepared to administer an IV in the event that it is required.
3. Do you use herbs? Do you use medications? Homeopathics? Acupressure? We want to be treated not just through antibiotics and interventions, but through a variety of modalities that take into account the entire picture of our well-being, our constitution and the impact of treatments on our baby. Find out what other skills your midwife brings to the birth.
PRESENTATION & PROTOCOL
4. What is your preferred treatment for Group Beta Strep?
If you don’t know about Group Beta Strep, asking the midwife to explain what it is and how it can impact your baby at the time of birth can also be a good way to get a taste of your midwife’s educational style. She should educate you about allopathic and non-allopathic treatments in a balanced, non-judgmental way. Does she explain things clearly in a way that you can understand? Ultimately she should leave the decision up to you.
5. At the moment of birth would you feel comfortable with the father catching the baby? Would you be willing to sit back and be more hands off if that is what I desire?
One family might desire that the partner catch the baby. Another mother might need a lot of physical support and contact in that moment. Another might feel that she wants to receive her baby into her own hands. It is important to note that for most of us cannot foresee exactly what we need until we are giving birth. Asking whether your midwife is open to what you think you might want does, however, give you relevant information. As one mother said “I want to feel like I don’t need to ask permission at my own birth”.
6. How early and how late in a pregnancy can a woman birth in your care? Do you only allow women to deliver their babies after 37 weeks pregnancy and before 42 weeks? Is there any allowance that you give to women if they go into labor either before these dates or after them? What other things would you transport to the hospital for?
7. What energy do you want present at your birth with you?
This is a question for you to ask yourself. Like the Native American sun dances, giving birth takes us on a psychologically demanding and physically perilous journey. Surrendering to this experience is life-changing. Our midwife is the one who makes the space for our birth to be whatever it is; who is calm in the face of intensity and responsive to the many vicissitudes of nature’s process. Someone who is more directive and assertive or someone who is more receptive and attuned might be a better fit for you. Most people desire a midwife who remains calm under pressure. The unfortunate truth is that it’s almost impossible to assess how your midwife will respond to an emergency situation until the moment is upon you. Pay attention to your intuition however. Listen, watch and reflect on what kind of energy your midwife has and her impact on how you feel.
8. In what position do women most commonly give birth in your practice?
If 95% of a midwife’s clients birth lying on their backs think about whether this is an acceptable position for you or whether you would prefer a greater range of possible birthing positions.
9. Lastly, how much do you charge? Do you have a sliding scale? Will my insurance reimburse me for all or any part your care?
Although finances can, at times, feel like the determining factor, spend as much money as is necessary to have the midwife who offers you the best fit while being the most experienced in her field. Think critically about the other things in your life on which you spend sizable amounts of money. A good example is weddings. Few, if any, things are as important as the health and well-being of yourself and your baby. This day, like a wedding day, is one that you will remember forever. It is your initiation into parenthood. Choosing a midwife who can offer you the aforementioned skills and presence can be the difference between a rocky entry and a smooth one.
Choose your midwife carefully. Choose someone who gives you the full scope of what you need in a home setting: Someone who brings an energy that calms and soothes you, while providing the information you need to make informed choices; who can also usher you and your baby safely through this sacred rite into your new lives together.