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           Natural Birth Stories: The Real Mom's Guide to an Empowering Natural Birth by Shannon Brown of GrowingSlower             
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Thursday, September 27, 2012

47 Questions I Should Have Asked My Midwife

I will admit, I didn't ask my midwife too many poignant questions when I was interviewing her. It was love at first site, and I was still blissfully unaware of all the unexpected situations that can arise in even a healthy low risk pregnancy. Looking back on my experience and those of many other women who have shared their stories, this is the list of questions I should have asked my midwife when I interviewed her. Luckily, everything turned out beautifully. We couldn't have been more happy with our decision to have a home birth and with our wonderful midwife as our care provider.

Don't choose a midwife or OB without asking them these 47 questions first! #naturalbirth
   (Image Credit)

Some of these I did ask during the interview. Some we asked in later prenatal appointments. Some came up when we were trying to explain our home birth decision to family. All of these are important, and the answers can help clue you into whether a particular midwife or obstetrician will be able to support you through a successful natural birth. Unforeseen circumstances may arise during your pregnancy or birth. It's great to have the peace of mind that when they do, you know exactly what to expect from your care provider.

Interview Questions...


Experience

1.   What is your philosophy regarding pregnancy and birth and your role in it?
2.   How many births have you attended?
3.   What percentage of women successfully have a natural birth under your care?
4.   What percentage of women need to transfer to the hospital (if planning a home birth or birth center birth)? What is the typical reason? 
5.   What percentage of moms end up with a C-section? 
6.   What percentage of moms end up with an epidural?
7.   What percentage of babies are transferred to NICU?
8.   What is the mortality rate for moms? For babies?
9.   Do you have hospital privileges? At what hospitals?
10. If you have children, what were your birth experiences like? 
11. How many midwives or obstetricians are on the team? Who are your assistants? Will I get to meet all of them? What is their experience? Can I be sure that you will attend my birth?
12. Do you deliver breech babies naturally? VBACs? Twins?
13. How many births do you attend per month?

Pregnancy & Prenatal Care

14. What usually happens at prenatal appointments? How many? When? How long are they?
15. Are you available by phone or email for questions?
16. What is your philosophy on weight gain, nutrition, prenatal supplements, and exercise?
17. What factors would risk me out of your practice? How will you help me prevent these? 
18. What child birth class do you recommend?
19. What prenatal testing to you encourage?
20. What type of gestational diabetes testing do you typically use?
21. Do you recommend ultrasounds? When? How many?
22. Do you typically do vaginal checks during prenatal appointments? When?
23. What happens if I go past my due date? How late can I be and still birth under your care (if a midwife)? 
24. What testing do you do for a late baby? Starting at how many weeks? 
25. Do you have any concerns about big babies being birthed naturally? 

Don't choose a midwife or OB without asking them these 47 questions first! #naturalbirth

Image Credit


Labor

26. When do you do vaginal checks during labor?
27. What type of monitoring do you do during labor? How often? For how long?
28. Do you routinely use an IV or hep-lock?
29. Are there birth tubs in each room in the birth center? What if one is not available when I'm in labor? 
30. Is a water birth available? If not, am I able to push in the tub at all?
31. How long do you recommend I stay in the water at one time? Do I need to get out for monitoring?
32. How many women are under the care of one midwife or doctor at a time? How much will you be with me throughout my labor? 
33. Are you comfortable working alongside a doula? Do you have particular doulas you recommend?
34. How long can I labor without induction?
35. When would you recommend induction? Do you use natural induction methods first? 
36. How long can I labor without intervention after my water breaks?
37. Who attends a birth? (Students, assistants, nurses, etc.)
38. When do you feel amniotomy is indicated?
39. Can I eat and drink during labor?
40. What's your process for implementing a family's birth plan?
41. What positions are available during labor? While pushing?
42. What are reasons you would initiate a transfer to a hospital (if a home birth or birth center birth)? 
43. How long do you allow for delivery of the placenta? When do you cut the cord? 

Postpartum & Newborn Care

44. What post-partum care do you provide? When? How many appointments? Where?
45. What does newborn care consist of? Under what circumstances would my newborn need to be taken away from me for treatment?
46. Are you comfortable with me declining bathing, vitamin K, heel poke, eye ointment, vaccinations? 
47. Can you help me initiate breastfeeding? 

The right answers

That was a lot of questions! So you might be asking yourself, what are the right answers? That might be different for everyone. In the coming weeks, I'll break down some of these questions to help you think about the different issues surrounding each one. For much more on preparing for birth visit the GrowingSlower Pregnancy and Birth Resource Page.

What was your experience interviewing midwives and obstetricians? What was the most important question you asked? 




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This post is linked up with Frugally SustainableSimple Lives Thursday and Your Green Resource


17 comments:

  1. Wow, I think I was one of those people who just picked a doc out of the book because they were in a good size practice near where I worked and went from there. I never interviewed anyone or even thought about it. julieann r

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  2. Awesome questions! I will definitely share this. :)

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  3. This is fabulous, Shannon! Well thought out. I am excited to see how you elaborate on these in the future. The most important thing I told my midwife was that my mom and sister had both had 3-4 day first labors. So, the most important question I asked her was "Given my family history, do you think I can have a natural childbirth?" She was completely unfazed and said yes. Because she knew what my mom and sister's labors were like, we focused a lot on labor prep (starting at 35 weeks) and talked candidly and calmly about what a hospital transfer would look like and why it would be needed. After 31 hours of labor, I did transfer to a hospital AND amazingly ended up having my baby just 3 hours later, without drugs and with my midwife there the whole time! Not what we expected, but wonderful nonetheless.

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    1. I love that your midwife was unfazed by your expected long labor. There are so many different versions of labor, but almost all of them are normal and safe to have a natural birth. I'm so happy you had a positive experience even though it didn't go quiet as planned. It sounds like you were very prepared, and as I am sure you know that is soooo important!!

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  4. Excellent list! One question I would add is, "What will happen if the baby releases meconium before birth?" My son was born with a midwife but in a hospital. I had no idea that if a little meconium was seen in the fluid, the hospital would TAKE AWAY MY BABY FOR TWO HOURS WITHOUT LETTING ME SEE OR TOUCH HIM FOR EVEN ONE SECOND. I am pretty sure that my freakout over this was the reason I had a dangerous amount of blood loss after the birth. My partner, who stayed with our son as long as allowed (the first hour of the two) later told me that the only treatment administered during that time was suction with a rubber bulb and patting baby on the back--they could have done that with baby near me and the cord still attached! But this was their standard practice for "respiratory distress" (baby was FINE; there was no sign of any breathing trouble whatsoever) and my midwife accepted it. I wish I'd at least known about the possibility in advance.

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    1. I am going to add a question to the list to reflect that issue. I am so sorry you had to go through that. I would have come unglued if someone took my newborn from me!! That must have been so hard for you and your baby. My baby born with meconium staining as well, and I can assure you (as can our entire neighborhood) that he had no respiratory distress because of it. He gave such a loud strong cry as soon as he was born. :) I'm glad we were at home, so I didn't have to worry about hospital protocols. I hope your story will help other women be prepared in case she finds herself in a similar situation. Thank you so much for sharing!

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  5. This is a great list! While I don't see myself ever having an unmedicated birth, I am interested in finding a post partum doula next time. Do those exist? With all the issues I had post partum I think it would be really helpful to have some extra support.

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    1. I think these questions probably apply somewhat regardless of what type of birth you hope to have. Even if you plan on having an epidural, I imagine we would all like to avoid other unnecessary medical interventions if possible, especially if they increase risk to mom and baby.

      Yes postpartum doulas do exist! Depending on the doula they can provide breastfeeding support, cook and clean, look after other little ones, or just be someone to talk to. I imagine it would be a great help with avoiding PPD.

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  6. This is a really great list! I loved the midwives who attended my daughter's birth 4 months ago, and I agree it is so important to feel like your birth team is all on the same page.

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  7. I didn't ask too many questions either. Just went with the practice because it was what was in our area. Last time, I went with an OB and was very disappointed. This time, I've noticed a significant difference in my care. I love how laid back the midwives are, and how open they are about everything and about helping me have a natural birth. I'm also having a doula attending. (The midwife practice I go to delivers in the hospital here, but my doula will be with me to labor at home as long as possible before going in.)

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  8. After my experience I think I would recommend to ask about the midwife's views on back labor and resolving it. My midwife was very hands off- too hands off. After over 24 hours of intense back labor I was in too much pain for any progression, but it wasn't until then that she said she thought I might be in back labor and suggested some positions to get the baby to shift. This was followed shortly after with her suggestion to transfer to the hospital. Also ask if they are going to stay with you at the hospital (ours didn't). Needless to say that I ended up with a highly medicalized birth and had a very beaten up baby (vaginally) who developed a lung infection, meaning we stayed in the hospital for a week, 3 days of which he had to stay apart from us in the NICU. And I don't think my story is that atypical, actually. We are trying a different midwife for this next time, and what her views are on labor with the posterior baby are at the TOP of my list!

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  9. I would add to the list, how do you manage the pushing stage? As a doula I notice that some midwives allow mother directed pushing while others are very involved in managing and directing 2nd stage. My preference is to let mom do her thing unless she asks for direction. Having the midwife yelling, "come on, push, push, push!" can be confusing and disturbing to a mom that is coping well and relaxing through her contractions.

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  10. You might want to ask how quickly your midwife can get to your house in the middle of the night ;) Ours missed the last one . . . which solved the issue of how long to wait to cut the cord. We waited until she showed up :D

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  11. As a midwife, I'd like to put in my feedback- this is a wonderful list!! I love it when a woman comes to an interview and/or prenatal prepared with questions! Talking back and forth strengthens our relationship & helps her feel more secure in her body and its ability to birth. I always feel better going into a birth if I have had some great discussions with the woman prenatally.

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  12. This is our first pregnancy and I have been trying to get a hold of a midwife here in New Zealand for days. Finally one answered! She will be calling me back soon for a phone interview and I have your list and a few of my own questions to ask. Thank you!!!! This will definitely be a life saver for me. Of course, a lot of terms I don't know yet, as I'm new to this and only 6 weeks aling, but I will still ask and write down every answer she gives. Again, thank you!!!!!! By the way, one question I am asking and the only personal one is her view on abortion as this does play a role in my trust for her and also her view on our tiny baby if she is caring for me this early on. I want her to value life as I do .

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