Interviewing a midwife

Consultation Questions for Prospective Midwives

Have you ever wanted to ask someone questions but then suddenly had your mind go completely blank when you finally have the opportunity?  Interviewing a midwife can be like that sometimes.  I’ve had many women come by for a consultation or interview and can’t think of what to ask.

So I got busy and compiled as many questions as I could think of that someone might want to ask a midwife. This list comes from my own interview experiences as well as looking at other people’s suggestions. I tried to think of everything but you might think of something I left out. So this is only meant to be used as a tool. My suggestion is to print it out and highlight the most important questions to you. Then take this with you when you have an interview scheduled. 

The following questions won’t necessarily be covered in just one interview, but you should know the following about your attendant prior to giving birth.  A good indication of the well-regarded midwife may also be her affiliation with state and national organizations. And does she offer an “Informed Choice Agreement”, a statement of her background and statistics?  This reduces confusion or misunderstanding later.  Try to circle the most pressing concerns or questions you have now, for the initial interview.

I.     TRAINING AND EXPERIENCE

  1. Where did you receive your training and who trained you? How long did you train as a student?
  2. What do you do for continuing education?  How often do you get continuing education and where do you get it?
  3. Are you trained in CPR and Neonatal resuscitation?
  4. How much of your training was hospital experience, home experience and birth center experience?
  5. How long have you been attending births as a primary midwife (not including student training)?
  6. How many births do you attend per month?
  7. How many clients required C-sections, episiotomies, suturing?
  8. Who attends births with you and what is their training? Are they certified in CPR and neo-natal resuscitation?

II.     COMPLICATIONS AND EMERGENCIES

  1. What complications and emergencies have you seen and how were they handled? (i.e. postmaturity, prolonged labor, fetal distress, mal-presentation, bleeding)
  2. How do you handle postpartum bleeding? Do you use herbs, massage, or medications?
  3. What circumstances/conditions would rule out your attendance?
  4. What complications/emergencies do you have experience with or have been trained can you handle?
  5. Under what circumstances do you transfer to a hospital?
  6. What percentage of your clients need cesareans in your practice?
  7. How often do you transport to the hospital? (Beware of anyone who brags about an extremely low transport rate or “hardly ever transporting”! This could be an indication that she is taking unnecessary risks.)

III.    MEDICAL BACKUP

  1. Do you have a consulting physician?
  2. Do you have standing orders for emergency medications and procedures? What kind?
  3. What hospitals are used and how well do they accept transports from your care? Are they hostile or supportive?
  4. Can you accompany the couple through a transport and hospital birth?
  5. Can you recommend family doctors or pediatricians?
  6. Do you refer to any other health care providers? Under what circumstances would you refer? 


IV.    EQUIPMENT AND PROCEDURES

Prenatal:

  1. Do you do prenatal care?  What is your schedule for visits?
  2. What is included in prenatal care?  (Should include risk assessment, lab work, sonograms, blood pressure, fetal heart tones, monitoring the growth of the baby, vaginal exams and postpartum follow-up)
  3. What nutrition counseling do you provide?
  4. Do you offer or recommend any birth preparation classes?
  5. (If planning a homebirth) So you visit the home at any time before the birth?  

During Labor and Birth:

  1. When do you want to be called once labor has begun?
  2. When do you come to the home (or do I come to the birth center) once labor has begun?
  3. What equipment do you bring and what must we provide?
  4. What emergency equipment do you provide?
  5. How do you view the father’s role?
  6. What is your role during labor? birth?
  7. How do you feel about sibling participation in birth?
  8. What non-drug measures do you suggest for pain relief?
  9. How often do you listen to the baby’s heart in labor?
  10. What is fetal distress in your opinion?
  11. How do you monitor for fetal distress?
  12. What do you consider prolonged labor/birth pushing?
  13. Do you have preferences for labor/ birth positions? 
  14. How do you feel about waterbirth?  
  15. What is your experience with waterbirth?
  16. What measures do you take to prevent tearing?
  17. What are your feelings about the father helping “catch the baby”? Is this allowed? Is it encouraged?

After Delivery

  1. Do you check for tears? (vaginal, urethral, rectal)
  2. Do you have local anesthetic & suturing equipment for this repair to be done without going to the hospital? Are you experienced at suturing?
  3. How do you prevent/treat excessive postpartum bleeding?
  4. How do you handle the baby immediately after birth?
  5. How long do you stay after the birth?  What do you check at this time?
  6. What is your schedule for follow-up care?
  7. Do you do the newborn screening tests? (required by the state)
  8. How is the filing of the birth certificate handled?
  9. Do you routinely give me a copy of all my records after the birth? Can I have access my records during the pregnancy? If so, how?

V.     FINANCIAL ARRANGEMENTS

  1. How much do you charge for your services?
  2. What services are not included in this fee?
  3. Do you offer payment plans or any discounts?
  4. Do you accept insurance?  
  5. How can I find out if my insurance will cover your fees? 
  6. What deposit do you require?
  7. Do you accept any other forms of payment? (i.e. credit card)
  8. When do you want the full fee paid?

VI.    ATTITUDE AND COMMUNICATION

During your interview, determine the midwife’s willingness to:

  • be open and honest in communication. (Is she honest even with difficult or controversial questions or is she only trying to tell you what you want to hear?)
  • explain things to you and educate you so you can be better informed
  • help you make informed choices and understand the possible consequences of those choices
  • encourage you to take responsibility for your own decisions

Other questions

  1. What are the advantages of a homebirth?  
  2. What are the advantages of using a birthing center?
  3. Any disadvantages to either?