Questions to Ask When Considering a Homebirth Midwife

Please note: I compiled this list of questions from various sources, but it is not intended to be all-inclusive. It is meant to help you choose a midwife and to gain a better understanding of the risks and benefits of home birth.

There are no right answers to many of these questions, and for those that may be seen as having right answers, due to the fragmented and largely unregulated nature of homebirth in the US, it may ultimately be up to you to sort out whether the answers you receive are accurate (i.e. in the best interests of you and/or your baby) or not.

Likewise, be aware that it is often debated whether CPMs, DEMs, and LMs have sufficient qualifications to practice homebirth midwifery and whether homebirth, even when supported by a CNM, is a safe choice. Nonetheless, the choice is yours.

Background

• What is your general philosophy about pregnancy and birth?

• What is your education, training, and licensing as a midwife?

• How many years have you been practicing?

• Do you work alone or with a partner or assistant? If you work with someone, what is her experience?

• How many births have you attended as the primary caregiver?

• Do you attend VBAC/breech/twin births? What is your experience?

• What are your guidelines or restrictions on who can give birth at home? What do you consider a low-risk/high-risk pregnancy?

• What is your policy for postdates? At what point do you consider a pregnancy postdates? After 42 weeks?

• Has any client filed a complaint against you? For what reason? Has the issue been resolved? If so, what was the outcome?

Financial Matters

• What are your fees and what do they include?

• Can you submit your charges to my insurance company? Or can you give me an invoice including your NPI that I may submit to my insurance company for reimbursement?

• What payment arrangements can we make?

Prenatal Care

• Do you come to my home for prenatal visits?

• How often will I see you?

• What do your checkups consist of?

• What are your guidelines concerning weight gain, nutrition, prenatal vitamins, and exercise?

• What tests or procedures do you normally recommend in pregnancy?

• Do you test for Group B Strep? Do you/how do you treat it?

• Do you require that I see a physician during my pregnancy?

• Do you provide supplies or literature to help me prepare?

• Do you require that I take a childbirth education class? Do you teach such a class?

• Who takes over for you if you go on vacation, get sick, or need to attend another birth?

Labor

• What kind of equipment do you bring to a birth?

• What emergency experience and/or training do you have? (i.e. CPR and neonatal resuscitation certification, IV and venipuncture certification, anti-hemorrhaging medicines, oxygen, suturing skills)

• When should I call you after my labor begins?

• Do you use or recommend any "natural" induction methods? Which ones?

• Do you sweep membranes to get labor going?

• How often do you do vaginal exams?

• How do you handle posterior babies?

• What is your policy on prolonged rupture of membranes?

• How much time do you allow for the delivery of the placenta?

• How soon do you usually clamp/cut the cord after birth?

Transfers and Emergencies

• Under what circumstances would you transfer?

• What is your transfer rate?

• What hospital would I go to?

• Would you stay with me in the hospital?

• How do you handle emergencies? (i.e. shoulder dystocia, cord prolapse, etc.)

• What is your cut-off for considering a baby premature and requiring a hospital birth?

• Have you had any bad outcomes, including death, for mothers and babies in your care? How many? What responsibility do you hold in these outcomes?

• Have you ever had to resuscitate a baby?

The Baby

• Do you regularly bulb suction baby after birth?

• Do you examine the baby after birth?

• Do you support immediate skin-to-skin contact?

• Do you give erythromycin eye ointment or a Vitamin K shot to the baby?

• Do you do newborn screening tests? (i.e. PKU)

• Do you have a pediatrician you work with or recommend?

• Will you help me with breastfeeding?

Postpartum

• How often do you come to see me after I give birth?

• For how long may I call on you for support?

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