Questions to Ask a Homebirth Midwife

This list includes many questions you may wish to ask a homebirth midwife during the interview process. Reading through the list may also help you think of other questions of your own. Because home birth midwives are not regulated in Ohio, it is your responsibility to ask lots of questions, ask for references, and feel good about your choice of midwife to care for you in your pregnancy and attend your home birth. Your “personality fit” or a particular midwifeʼs style may be as important as her answers to your questions.

General Questions • Tell me about your training / education / background and how you became a midwife? • Are you certified or licensed and by whom? • How long have you practiced? Approximately how many births have you attended?

*Would you give me the name of a few clients as references? • Do you work alone, or with another midwife and/or an assistant? • What is your transfer rate? Typical reasons for these? • Are you available for phone calls / text messages 24 hours a day for advice/

emergencies? • How do you determine the due date? • What are your experiences with/opinions of Bradley? Hypnobabies/hypnobirthing? • Do you encourage your clients to write birth plans? What is the intended benefit of

them? • Will you be okay with attending my birth if I go into labor at, say, dinner time on

Christmas Day? • Do you maintain statistics from your practice? May I see them? Do you participate in

regular peer review? • Do you currently have a student/apprentice? Will they be at my appointments and/or

birth?

Risks • What situations would cause me to “risk out” of home birth during pregnancy? During

labor? • Are your guidelines or restrictions about who can give birth at home strictly enforced? • What happens if I go past 42 weeks? Before 37 weeks? • Do you ever attend twin births? • What if baby is breech? • I have x, y, and z medical conditions. Can I still have a homebirth? How could my

conditions affect my pregnancy/birth/baby?

Prenatal Care • What are your expectations of clients during pregnancy? • Do you require parallel care with an OB? Do you have a collaborative agreement

with any hospital providers? • Where do your prenatal appointments take place? • Can you describe a typical prenatal appointment?

• Can my birth partner attend my prenatal appointments? My kids? • What prenatal tests/monitoring do you recommend/perform routinely? (BP, weight,

urinalysis, ultrasound?) • Do you order labs? • Do you suggest testing for GBS, and if Iʼm GBS+, what do you suggest? • Do you suggest testing for Gestational Diabetes? How do you test for GD? What

would happen if I have GD? • What are your standards for preeclampsia? How do you manage this condition? • Do you use a Doppler or fetoscope at prenatal visits? How often?

Labor • What are your expectations of clients during birth? • What supplies do I need to provide for the birth? Where can I purchase those

supplies? • What medications, if any, do you recommend having on hand? • Who else will come with you to the birth? • At what point in my labor will you come to me? How long will it take for you to get to

me? Will you stay with me during my whole labor if I want you to? • How many clients do you have due in any month? And what is the plan if I go into

labor while you're with another laboring client? • Have you ever missed the birth of a client? If so, what were the circumstances? • What equipment do you normally bring to the birth? • Are you okay with my older child(ren) being present at the birth? • How long do you let things go after membranes rupture? • What if you suggest a transfer but I don’t want to transfer? • Would you be okay with mostly being in another room, if I wanted to labor and/or

deliver alone or only with my birth partner in the room?

First/second stage • What do you perceive your role to be during my labor? • How do you monitor the baby during labor? • Do you perform vaginal exams? • Under what conditions would you perform artificial rupture of membranes (AROM) or

otherwise induce or augment labor? • What natural comfort techniques do you provide? • Are you comfortable with a water birth? When would you not allow a water birth? • What pharmaceuticals, homeopathic and/or herbs do you use at births? • What is your usual approach to a labor that is progressing slowly? • How many/few people are you comfortable with being present at the labor and birth? • How do you deal with shoulder dystocia? • How do you deal with cord prolapse? • How do you deal with meconium present in the amniotic fluid? • What percentage of your clients tear, and how badly? How do you try to prevent this? • How long are you willing to let a client push? • How do you think the pushing stage should be managed?

• If I or my birth partner wish to catch the baby, are you comfortable with me/them doing so

• What positions do your clients most often give birth in? What positions do you prefer, and why?

Third stage and immediate postpartum • How much time do you allow for the delivery of the placenta? • Are you okay with the placenta being delivered underwater? • What is typically done with the placenta afterwards? Are there any legal restrictions

on disposal? • Do you recommend eating or encapsulating the placenta? Do you provide this

service? • How do you detect partially retained placenta? How do you treat this? • How often do hemorrhages occur? • How would you handle a hemorrhage? Do you carry Pitocin or herbs for this?

Legally? At what point would you recommend transfer for medical management of hemorrhage?

• What are the most common minor complications you see, and how do you typically treat them?

• What happens if my perineum needs stitching/suturing? Can you do that? Are you comfortable with repairing 2nd/3rd/4th degree tears? How bad does a tear have to be before you use stitches?

• Do you help with cleanup (laundry, etc.)? What do you typically do? • How long do you typically stay after the birth?

Baby • How do you resuscitate baby, if needed? Are you certified in neonatal resuscitation?

How many babies have you resuscitate? • When do you usually clamp and cut the umbilical cord? Can I or someone else cut

the cord? • What would you do for a floppy baby? How often do you see this? • What is part of the newborn exam? • Can you diagnose tongue/lip ties? • Will you send newborn records to my pediatrician? • What if I would like my baby to be circumcised? • Do you administer Vitamin K? Erythromycin (antibacterial eye ointment)? Vaccines? • Will you do the newborn screening? • How will I get the babies birth certificate?

Complications • Do you have a working relationship with one or more particular OBs to whom I would

be referred in the event of a complication? • How do you coordinate care with an OB for complications during pregnancy? • What hospital would you prefer I transfer to? What situations do you consult an

obstetrician for? How commonly do these occur? What problems or complications in

pregnancy would mean that a obstetrician would become my primary maternity caregiver?

• Under what circumstances do you transfer to hospital? • What hospital would I be transferred to? • What kind of relationship do you have with the OBs/midwives at the hospital? Do you

coordinate care with them? • What would be the plan of action if a transfer to hospital were necessary during

labor? Would you stay with me in the hospital? In the operating room? For how long after the birth?

• Under what circumstances would the baby transfer to the hospital? What role

Postpartum • Do you have any special things you do for the mom after a birth such as an herbal

bath? • How many postpartum visits will there be? Where will these take place? What do they

include? • Are you on call for postpartum emergencies? • What conditions could require a postpartum hospital transfer? • Do you examine the baby at your postpartum visits? And if so, what does the

examination include? • When do you recommend that we take the baby to the pediatrician for the first time,

and why? • Do you provide lactation consulting? Or what would you recommend for

breastfeeding problems?

Financial • What are your fees? Can I make payments? Would you barter for services? • Will you bill my insurance company? How? • What is included in your fees? What will I need to provide? (Birth kit, tub, etc)