Friday, February 26, 2010

Interviewing Midwives

You can use these suggestions to interview any care giver, doctor or midwife. The first thing to consider when putting together a list of questions, is what you want your birth experience to be. What are your preferences for birth and what do you want to take from your experience? What are you looking for in a care provider? Consider your own personality and that of your partner, and think about the kinds of characteristics you would hope for in your midwife. You might want to write these things down to help you formulate an idea of what to look for and what to ask. You may find that you will have to interview every midwife in your area before you decided on the right one, or you may find the right midwife with the first one you interview. It's a good idea to interview more than one, because you may find one you like better than the first. Some things to think about:
  • Talk with the midwife about your birth wishes, and see how open she is to your desires. Writing down your birth wishes or birth plan and taking that with you to the interview will help you stay on track and remember to cover everything. You may also want to bring a notebook with you to write down her answers and your thoughts about them.
  • How do you feel when talking with her? This is one of the most important things to consider. This person will be monitoring your care throughout your pregnancy, and when it comes time to have a baby she will be in your most intimate space. Having a good rapport with your midwife is going to increase your comfort level and make labor and birth a smooth process. Your partner's comfort level with her is just as important.
  • How "hands-on" is she? If you are looking for a midwife who will jump in and give you physical support during labor (like counter pressure,massage, etc.) and be at your side throughout the birth, this can be an important question to ask. Some midwives are more laid back and tend to watch and wait more than give active physical support.
  • What type of labor support persons does she provide? This includes any attendants, other midwives, midwifery apprentices or doulas she will bring with her to the birth. CNM's in the hospital will not have additional support people other than the nursing staff, but a CPM or DEM attending a home birth may have colleagues or apprentices who attend births with her. If you prefer more support than your midwife will provide, you may want to consider hiring a doula to provide the extra support you desire. My home birth midwife had a group of midwives and apprentices who worked with her, and I was able to choose which people I preferred to have at my baby's birth.
  • What could necessitate a transfer of care to a physician? If you plan to give birth in a hospital, knowing what red flags will prompt your midwife to transfer your care to a supervising obstetrician can be very helpful. The answer may not differ from one midwife to another, but knowing the possibilities can help you be prepared for any eventuality.
  • What is her hospital transfer rate? If you are planning a home birth, knowing how often your midwife transfers her clients to the hospital can be helpful in knowing what your chances of transfer could be. Ask her the reasons she would transfer from home to the hospital.
  • Is she willing to let you labor or give birth in water? This was high on my list of priorities, but it may be less important to others. I heard a story about a midwife who was unwilling to allow first-time mothers to give birth in the tub, because she didn't want to be "up to her armpits in water" for an extended period of time.
Most questions will vary depending on your specific wishes, including third stage management (whether she routinely gives pitocin to help deliver the placenta or allows the body to expel it naturally), how she would handle a positive Group B Strep screening (antibiotics or other methods), how often she performs an episiotomy, etc. Your birth wishes and questions for the midwife will also depend greatly on your choice of where to give birth.

Don't be afraid to ask a lot of questions and be selective. This is a big decision, and your midwife will work for you, not the other way around.

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