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HOW TO CHOOSE A MIDWIFE

Suggested Guide for Questions When Choosing a Direct-Entry Midwife

Written primarily for women in Texas by Claudine Crews, CPM, LM

I.               QUALIFICATIONS AND EXPERIENCE

1.                    How long have you been a midwife?

2.                    Are you licensed or certified?

3.                    What is your training? Where did you train - home, hospital, birth center? How were you trained?

4.                    What is your experience? How many births have you attended in total?

5.                    How many of those births were planned, out-of-hospital births (If you are planning for an out-of-hospital birth?)

6.                    In what capacity were you there at these births?

a.               As a friend, observer, doula, support-person?

b.               As a student or apprentice midwife?

c.                As an assistant midwife?

d.               As a primary (or primary under supervision) midwife?

7.                    What complications do you have experience handling? (IE, hemorrhage, resuscitation, cord prolapse)

8.                    Are you certified in CPR and NNR (Neonatal Resuscitation) and when do these expire?

9.                    Ask about any special training, if interested, such as VBAC, waterbirth, twins.

10.                Ask for references. If you are interviewing a newly licensed midwife you might ask for references from her preceptor or her "primary under supervision" clients.

 

II.             PRACTICE AND PROCEDURES

1.                    Where do you work? At homes, birth center? Where do you see clients prenatally?

2.                    Do you work alone or with an assistant at births? What are her qualifications?

3.                    What equipment, supplies, herbs, medications, etc., do you bring with you to a birth?

4.                    What do you do in the event of a complication during labor? What are some scenarios that would indicate need for transport during labor or the immediate postpartum period?

5.                    What happens if I develop a complication during pregnancy?

6.                    What back-up arrangements do you have if you are ill or must be out-of-town?

7.                    How many clients do you accept who are due within a few weeks time of each other?

8.                    What is your plan/policy if you have more than one client in labor at the same time?

9.                    What tests (blood, urine, cultures, ultrasound, genetic, newborn, etc.) do you require? Which do you advise or recommend routinely? What if we disagree on if I really need these tests?

10.                Do you have any routine procedures or policies regarding labor and birth, such as going past-due, food and drink intake, breaking the bag of water, episiotomy, length of labor, number of people there for the birth, siblings present, photographs or video-taping of the birth, vaginal exams, use of water during labor (tubs, pools) - any anything else you can think of.

11.                How do your clients contact you after-hours? Cell phone, pager, answering service, apprentices?

12.                Do you work with apprentices? What part would she have in my care?

IF APPLICABLE

13.                Do you attend VBAC clients? Do you have any special policies, requirements, or restrictions?

14.                Do you offer Waterbirth?

III.           PERSONAL

1.                    What are your beliefs or philosophies relating to birth?

2.                    Why did you become a midwife?

3.                    Do you have children? If so, where were they born? Did you have a midwife for your own births? Why or why not?

IV.          FEES

1.                    What is your fee?

2.                    What does it cover?

3.                    What does it NOT cover?

4.                    When is the fee due?

5.                    Do you accept insurance?

6.                    Do you accept credit cards?

7.                    Will you work out a payment plan?

8.                    What is your refund policy if care is terminated during pregnancy?

9.                    What is your refund policy if care is transferred during labor?

OTHER

If you are interviewing a Certified Nurse Midwife instead of a Licensed or Certified Professional Midwife, in addition to the above questions, you will want to know what hospital she works at and whatever the policies are there, such as routine IV's, withholding food and drink, newborn nursery policies, etc. You will also want to know the physicians she works with and their policies. For example, if her back-up doctors will not attend VBACs she probably will not be able to help you either - she is limited by their protocols. If she is in a group practice you will want to know the on-call arrangements - are you guaranteed to have her attend your birth or is it whoever is on call?

 

Note any other questions you think of here: ______________________________________________

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