Choosing your birth team is one of the most critical decisions you will make in your entire pregnancy. These are the people who will (or should!) support YOUR choices throughout your pregnancy, birth, and postpartum periods.
Transparency can be a hard thing to find with some providers. The first step when choosing anyone to put your trust in to is to check in with yourself! What does your intuition say? Next step should always be to do a general background check on any one you invite in your birthing space. Luckily, we now have the internet, so this can be done rather easily. After those two key check ins, you can use this list to help you decide who will be the best fit for your family.
Some of these questions are tailored to homebirth midwives in the state of Florida. If you are interviewing midwives in other areas, you may want to find out what regulations or special situation midwifery faces in your state and local community and adjust your questions appropriately.
1. Are you Licensed by the State of Florida? Have you ever had any action taken against your licensed? (You can check any midwife's license in Florida here whether they are an LM or CNM. Be sure to ask if the midwife has ever gone by any other name such as a maiden name or name from a previous marriage so you can do a through check.)
2. Have you ever been convicted of a crime?
3. Have you ever lost a mother or baby? Have you ever been sued because of a poor outcome? What were the circumstances? (In this line of work, there are always going to be poor outcomes. It is just the nature of what we do. If the midwife is truthful about her history, you will have to use your own judgement on the one-sided information she will provide to determine if you are comfortable with her explanation. Some poor outcomes and deaths are avoidable, while others are not. It is also important to point out that Doctors face the same issues- usually more so! Anyone who attends births long enough will unfortunately see some negative things, remember that this is a part of life and usually very traumatizing for the care provider as well- so tread lightly here!)
3. Why did you become a midwife?
4. What did your training consist of? Do you have any speciality training? Did you pass your board exam on the first try? If not, why?
5. How long have you been attending births as a primary midwife?
6. Are you connected to the community? Do you know of parenting support groups, natural living groups, birth networks, etc that you could connect me with? Are you able to appropriately refer me to other local trusted professionals if I were to need something outside of your scope?
. Prenatally, what type of problems would risk me out of your care? Do you have a consulting physician I would see in those instances?
8. How much do you charge, and by what date would the full amount be due? What does that fee include? Do you accept payment plans? Do you work with insurance companies? What is your refund policy if we decide to switch care providers?
9. Who are your birth assistants/staff members? What is their training and background? How long have they been working for you? (NOTE: A high turnover of staff is a RED FLAG! Why has no one wanted to continue working for this midwife?) Will I get the opportunity to meet them before my birth?
10. Who is your back-up midwife? Where do they live in proximity to me? Will I have the opportunity to meet them? (Be sure to research your potential midwife's back-up as well! A midwife without a confirmed back-up is another red flag!)
11. What is cause for transfer during labor? Do you have a preferred hospital in my area for transfer? What would you say your transfer rate is? (An appropriate transfer rate to keep homebirth a safe choice is about 10-12%. The cesarean rate for most midwives will be about the same which is the World Health Organization's recommendation to decrease maternal and infant morbidity and mortality.)
12. What equipment do you bring with you to a birth? Could you show it to me?
13. Are you and all of your assistants trained and certified in neonatal resuscitation and CPR?
14. How many births do you take on per month/year? (Any midwife who works by herself can typically only care for 3-7 clients per month without having to constantly call on a back-up or compromising the quality of her care)
15. Are you planning any vacations or other major events around the time of my due window?
16. Where do my prenatal visits take place?
17. What kind of postpartum care do you offer? Do I have to come to your office or do you provide home visits in the early postpartum period?
18. My partner has fears about home birth. How have you dealt with this in the past?
19. What is your preferred method of communication? Do you keep normal business hours aside from births?
20. Could you provide me with contact information for previous clients to give a personal referral? (Check with other families in your community, look for information online, and read reviews of each midwife you are interviewing!)
This list is just a springboard to steer you in the direction of a honest, dependable, and competent midwife. You may have lots of specific questions about things like a midwife's philosophies, practice style, and protocol that you may want to add in. Take your time in your consultation and have the questions you want to ask in front of you so you don't forget anything. Remember to interview several midwives and do your homework! Don't ever settle for a midwife because her fee is cheaper or because your friend says she is good! This is YOUR big decision, own it!