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Old 01-03-2013, 05:45 PM   #1
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Homebirth...what to ask the midwife?

Im about to email the midwife in this area who does homebirth and realize I probably shouldn't bombard her with questions in the first email (which I almost did)
But Im wondering what I should be asking her before we start with her. There is another midwife who lives outside our area but will drive here.. and there is a birthing center where I already know the midwives and they are great. So I want to make sure we're considering everything there is to consider, even though we will probably go with the MW who lives here.

I know I should ask about what she looks for as far as signs of distress in the baby, when she would transfer, her plan and relationship with those who she transfers to (in the hospital. I know the birthing center MWs have a great relationship with the hospital staff)... what her response would be to signs of distress, etc...
But not sure if there are more specific questions than that I should be asking...

TIA
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Old 01-03-2013, 06:48 PM   #2
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I would ask if she has hospital rights. My hb midwife has them at the closest hospital to me so I knew she could still deliver a vaginal birth if we had to transfer. Also does she offer a free consultation so you could meet with her and ask questions in person?
I would also ask if she has had negative outcomes and if yes, what type.
I'll try and think of more
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Old 01-03-2013, 07:04 PM   #3
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Re: Homebirth...what to ask the midwife?

Things to start off with-

* What is your philosophy of birth

* What education and training do you have in pregnancy, childbirth and postpartum care

* Do you have hospital rights

* If you don't have hospital rights, and I need a transfer, do you continue to stay with me or do you just leave

* What are reasons you'd discontinue my care

* What are reasons you'd suggest a transfer of care (pregnancy, labor, postpartum)

There are many more I'd ask, but probably not until after these ones are answered first
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Old 01-03-2013, 07:50 PM   #4
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Re: Homebirth...what to ask the midwife?

I am a little crazy I interviewed 7 midwives and asked them all these questions,
1. What services do you offer?
2. What are the prices for your services and how do you work payments?
3. Do you have a billing service to deal with my insurance?
4. How do you make sure that the full placenta is passed to avoid a hemorrhage? (very important, this is why I was hospitalized and almost died after our miscarriage.)
5. What techniques do you recommend in labor to cope with pain management?
6. How do you feel about delayed cord clamping?
7. What are your "red flags" for transferring to the hospital?
8. If we transfer will you come with us and how is that handled?
9. What if our baby is breached?
10. What are your birth stats, how many mothers have transferred, how many deaths (if any), and how many of your clients end up with c-sections?
11. Are you currently certified as a midwife and by what organization?
12. What life saving measures are you currently certified in?
13. Do you participate in formal peer review with other midwives?
14. How many births have you attended?
15. If you are sick or otherwise unavailable during my labor, who will attend to me?
16. How many clients do you take each month?
17. How familiar are you with procedures in the hospital?
18. How long are you willing to wait for a baby in a bad position to change positions before labeling the pregnancy high risk?
19. What percentage of your clients tear and how do you try to prevent tearing?
20. What equipment do you normally bring to the birth (birthing stool? blow-up pool? oxygen? ambu-bag? pitocin shot?)
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Old 01-04-2013, 12:35 PM   #5
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Re: Homebirth...what to ask the midwife?

In an email, I would simply ask for a live appointment where the two of you could meet to see if it is a good fit for you to work together. In phoenix, all the midwives offer this service for free, so that may be true in your area.

Then, when you are together, you can ask all the above questions AS WELL AS figure out if you actually like her/trust her/bond with her.

I wouldn't ask anything in an email about birthing procedures, etc b/c you can't get a sense for attitude, tone
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Old 01-12-2013, 12:17 PM   #6
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Re: Homebirth...what to ask the midwife?

Thanks for all the awesome suggestions!! Any other things I should ask her? I just really want to make sure we're being careful and as safe as possible... but not very knowlegeable about what can go wrong and how to prevent that... yk?
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Old 01-14-2013, 07:41 AM   #7
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Re: Homebirth...what to ask the midwife?

I really like the discussion here: http://navelgazingmidwife.squarespac...homebirth.html The post links to some other posts as well that have good information.

I think it is also very important to talk to others who have used the midwife. And of course if you ask the midwife for references, she'll give you the best ones. You really want to know if there are mamas who had negative experiences or were dissatisfied, and unfortunately, it is really, really hard to get to this information. If you happen to live in a state with official regulation for HBMW, this should at least be a bit easier. I'm not trying to be grim or anything, and I like to think the best of people, but MWs are making a living at this, and if they have had unhappy clients, they aren't very likely to tell you about it, kwim?

I'd also add some questions like:
~Have you ever had to resuscitate a baby?
~Have you every had to resuscitate a mother?
~Have you ever personally encountered a serious PPH and how did you react?

MWs train in normal birth, which is great, except the thing is, we aren't really paying them to handle our normal births, we are paying them to know when are births *aren't* normal and to advise us when to seek more advanced care and to provide emergency support in the interim. I want to know that my MW is skilled at identifying when something leaves the realm of normal and providing emergency care until more skilled care can be attained. If she's read about emergencies in a book and taken CPR classes, but never had to use those skills irl, she isn't safe enough of a provider for me personally (but of course I totally understand we all have different thresholds of safety - I'm just trying to give you some things to consider as you work through this). Keep in mind that answers to a lot of these questions are "easy" to have good textbook answers too, but that doesn't necessarily equate to real, hands-on skills. These are the things I want to evaluate when talking to a midwife, personally, and try to come up with questions to this point.

I hope that helps you some as you put together your question list :-) GL, mama!
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Old 01-14-2013, 12:48 PM   #8
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Re: Homebirth...what to ask the midwife?

Quote:
Originally Posted by klevmomma View Post
I really like the discussion here: http://navelgazingmidwife.squarespac...homebirth.html The post links to some other posts as well that have good information.

I think it is also very important to talk to others who have used the midwife. And of course if you ask the midwife for references, she'll give you the best ones. You really want to know if there are mamas who had negative experiences or were dissatisfied, and unfortunately, it is really, really hard to get to this information. If you happen to live in a state with official regulation for HBMW, this should at least be a bit easier. I'm not trying to be grim or anything, and I like to think the best of people, but MWs are making a living at this, and if they have had unhappy clients, they aren't very likely to tell you about it, kwim?

I'd also add some questions like:
~Have you ever had to resuscitate a baby?
~Have you every had to resuscitate a mother?
~Have you ever personally encountered a serious PPH and how did you react?

MWs train in normal birth, which is great, except the thing is, we aren't really paying them to handle our normal births, we are paying them to know when are births *aren't* normal and to advise us when to seek more advanced care and to provide emergency support in the interim. I want to know that my MW is skilled at identifying when something leaves the realm of normal and providing emergency care until more skilled care can be attained. If she's read about emergencies in a book and taken CPR classes, but never had to use those skills irl, she isn't safe enough of a provider for me personally (but of course I totally understand we all have different thresholds of safety - I'm just trying to give you some things to consider as you work through this). Keep in mind that answers to a lot of these questions are "easy" to have good textbook answers too, but that doesn't necessarily equate to real, hands-on skills. These are the things I want to evaluate when talking to a midwife, personally, and try to come up with questions to this point.

I hope that helps you some as you put together your question list :-) GL, mama!
This link is SO helpful, and your advice is great. I'm really seeing a lot I need to ask now. Thank you!!
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