Questions to Ask a Midwife
Is the midwife nationally certified as a CPM (Certified Professional Midwife) or a CNM (Certified Nurse Midwife)?
Is she involved in the state midwifery organization and regularly attends local peer reviews?
What sort of training did she receive?
If she was apprentice trained:
When did she apprentice?
How long did she apprentice?
Who was the midwife largely responsible for her training?
How many births did she attend as an apprentice?
If she was trained in an institution i.e. birth center or hospital, get the details of that training.
Ask how much homebirth experience she has had beyond institution-attended births.
How many homebirths has she attended as a primary midwife?
Can she provide references of families whose births she attended as a primary midwife?
What kind of complications has she had to manage as a primary midwife?
Ask general questions about her “statistics”, e.g.
How many of the families she works with are referred for medical care or “risked out” during their pregnancies?
How often does she transport families to the hospital during labor? Why?
What is her c-section rate?
What sort of morbidity and mortality has she experienced in her practice?
Ask questions which give you a good sense of the scope of her practice, e.g.
Does she provide a program of prenatal care? What does this involve?
Does she provide nutritional support during pregnancy and labor?
Does she safely incorporate the use of herbs, essential oils, homeopathics and alternative medicine during pregnancy and labor?
What lab work does she require/recommend?
What about ultrasounds?
Does she provide postpartum care? What does this involve?
On what occasions (besides the birth) does she come to your home to provide care?
How long does she stay with you after the birth?
Does she provide breastfeeding support?
What is her experience with breastfeeding difficulties?
Will she give you a copy of her protocols?
What does she consider high risk?
What circumstances would necessitate a transfer of care to an OB?
What equipment does she carry?
What about medications?
Does she have experience in suturing if it is needed?
Does she have a relationship established with any local medical caregivers?
What sort of arrangements does she suggest for obstetric and pediatric medical back-up?
Does she accompany you if you need to go to the hospital?
Be sure to establish at the onset the details of the midwife’s fee structure and her policies on various fee-related issues. e.g.
Exactly what is the fee and what does it cover?
Payment options and when is full payment expected?
What if you move or change midwives during the pregnancy?
What if you have to go to the hospital?
Does the midwife's fee cover the services of an apprentice/assistant?
Is any portion of the fee refundable for any reason?
Who does she bring to the birth to assist her?
What is their training?
How many births as an apprentice/assistant have they attended?
Does everyone attending your birth have current certifications in Neonatal Resuscitation (NRP) and CPR?
Have they ever had to use these skills?
When does she consider herself on-call for you and how does she maintain her on-call status? e.g.
Any plans to travel?
Ask questions about how she manages her practice in case of a birth conflict. e.g.
How likely would there be a birth conflict?
How many births does she attend per month?
Does she work alone in her practice, or does she have partners, or apprentices?
How will these other women be involved in your care?
Who will back her up and attend your birth if she is unavailable when you call?
Will you have any prenatals with that midwife?
How experienced is that midwife?
Does that midwife carry the same equipment?
Would that midwife bring an apprentice/assistant?
Are there any additional fees for that midwife and her apprentice/assistant that you would be responsible for?
What would happen if that midwife was unavailable?
Think about specific aspects of your care that are personally important to you, and question the midwife about those issues. e.g.
Does she encourage your partner to be fully involved?
Does she involve your other children in your pregnancy and birth care?
Is she comfortable and experienced with water birth?
Does she bring a birth stool, does she safely incorporate the use of herbs, essential oils or homeopathics into her practice?
Does she respect your personal spirituality, requests and preferences?
Does she work with a billing service to help clients with insurance claims?
What are the fees to the billing service?
Do any clients receive reimbursement?
Generally you should spend enough time in consulting with a prospective midwife to get a good feel for her personality and style. You might, for instance meet two midwives who are each clearly competent and capable, and choose one midwife over the other based largely on more subjective issues related to personal compatibility.
We hope that this information has given you some ideas, and that it has stimulated you to think of even more questions!