Wednesday, January 7, 2015

Choosing a Midwife

When we for sure decided that we were going to do a home birth with baby 2.0 I started my hunt for a reputable, kind, loving, gentle midwife who I got along with. It was no easy task.

It's stressful choosing a doctor to deliver your baby in a hospital but with a midwife you're meeting a lot of them in their homes, and while this is pretty much how it's done, it can be hard to get used to when you're more familiar with doctor's offices.

Granted, my care so far has been fabulous. My appointments have lasted well over an hour each time and not because I've had to wait. I get all my questions answered in the fullest way possible. At my last appointment, my midwife took me into her kitchen to let me try a tea she recommended and some trail mix that she combines herself. She didn't give me one-word answers but very thorough in depth responses. And I enjoy her company so much that I didn't even realize how much time had passed.

Point 1 for midwifery.

But I interviewed quite a few midwives before I found the one I KNEW I wanted. Today I want to give you a little advice on how to find a great midwife.

Step 1: What kind of midwife do you want?

There are all sorts of confusing initials when dealing with midwives, so let's clear some of those up.

CNM Certified Nurse Midwife. A CNM becomes a nurse before becoming a midwife so they are trained and certified in two fields. Generally they only work in hospitals.

CPM Certified Professional Midwife. A CPM is an independent professional who has met the standards and certification through the North American Registry of Midwives. They are trained to work out of a hospital environment.

CM Certified Midwife. A CM has the same certification of midwifery as a CNM, they difference being that they didn't get certified as a nurse as well.

DEM Direct Entry Midwife. A DEM is trained through self study, apprenticeship, a midwifery college or university program that is separate from the nursing discipline. They are trained to provide the Midwife Model of Care primarily out of the hospital. This includes a Licensed Midwife (LM) and a Registered Midwife (RM).

Traditional Midwife. A traditional midwife is someone who has generally gone through the same training as a DEM or CM but has decided not to become registered or certified. They do this to get around any laws that the state may have to allow them more freedom with their clients in the birthing environment. However, since they are not licensed, they cannot carry the same medication that a licensed midwife can. Every traditional midwife that I have met works in a team of midwives that includes some that are licensed and have access to medication.

Step 2: Candidates

I took to Facebook for my initial search. I am a part of a mother's forum group in Utah on Facebook. You might want to do a little search and see if there is something like that for your community too. Usually they are closed groups so just request to join.

I just wrote a post requesting people's favorite midwives in my area and I had my starting list. This was also nice because if anyone had a negative experience with a midwife they messaged me and told me. From my list I googled the names people had suggested.

I found quite a few websites complete with their education, how long they've been practicing, their beliefs about child birth and some even had a team that work with them. I learned a lot from their websites but I still had questions, so I needed to make an appointment.

Not every midwife had a website that included their education and mission statement but they all had phone numbers so I started calling. I have yet to meet a midwife who wouldn't do an initial meet and greet with me for free.

**Note: It's difficult to get people you don't know on the phone when you have a Hawaii area code like moi.

Step 3: Interviews

In preparation for my interviews I came up with a list of questions, printed them out and put them on a clipboard so that I could take notes and remember who said what. I might have looked a little over the top, but I was interviewing so many that I really wanted to make sure I didn't get anyone confused.

Many out of hospital midwives have home offices. So when you go for your interview the first thing you want to pay attention to is a general first impression. Is their home clean or cluttered? Does their home office make you feel comfortable? Are there other family members around? Does any of this bother you?

I met with one midwife who seemed very nice but her home office was in the basement with very little light and honestly I just didn't like the vibe I got. First impressions and vibes are important because you HAVE to trust this person and feel comfortable with them.

Questions to ask:

Policies and Education
Price and Payment plans
What is your schooling and certification? How does that limit you?
What level of risk pregnancy do you take?
Where will I get blood work and other tests done?
Will I have ultra sounds?
What is your policy on past due?
What if my water breaks?
Should I get a doula?
What is a typical prenatal appointment like?

Past Births
How many years have you been practicing?
How many births have you attended? Been in charge of?
Do you normally do any interventions like episiotomy or break water? Are you willing to?
Transfer rate?
Have you had any loss, mom or baby?

When can I call with questions?
Do you turn babies? What is your method?
What do you recommend to maintain a healthy weight during pregnancy? Diet? Exercise?

What equipment will you bring to the birth? What medicines? Oils?
What type of newborn exams do you perform?
Do you do a full clean up afterwards?
What do you do to help with pain management?
How long am I allowed to labor?
What will I need to have for the birth?
Who will be at the birth?
What sort of complications would send me to the hospital?
Do you have a relationship with a doctor in the event of transfer?
What is your protocol in the event of a miscarriage or still birth?
What if I'm too tired to push?
What if I don't progress during labor?

Notes, impressions, feelings:

Step 4: Choose your midwife

Once you're done with interviews it's time to review your notes and choose someone. For me, a lot of prayer also went into this decision. And at this point, 17 weeks along, I'm still very happy with who I chose.

Do you have any other advice for how to choose a midwife? Any other questions you might ask? How did you find your midwife?

**The photographs in the post of my darling Evelyn were taken by none other than the fabulous Kensie M Photography.**

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