Interviewing your Potential Birth Team – How to Select a Midwife by Asking Important Questions

By Lori Mork, Doula

I have written before about selecting a location for your upcoming birth, or how to choose between a midwife or a doctor/obstetrician. But more important is HOW you select these people who will be a huge part of your birth team and your overall birth experience! In this blog I will list some good questions to get the conversation flowing with potential midwives you are looking at having as a part of your birth team. (At the end of this blog I will include a list I compiled of midwives available in the Lower Mainland and Fraser Valley areas I serve as a doula (and a link to their website with the intake forms where you can submit for a meeting to interview them!) …. this list isn’t as recommendations or in any way saying who is good or isn’t. Who will align with your preferences and goals within your birth space. It is merely a resource, a master listing of options you have – please do your due diligence and interview, be picky, and choose the one that feels right for YOU!) (To note – I do have my favorite midwives who I would stalk to be at a birth with because they are so amazing and truly have the best practice aligned with my experiences as a doula… but that is for my own knowledge and preferences. If you do ever want to reach out to me about anyone, I would always be happy to share my experiences, and references. I am not shy in shouting from the rooftops the ones I truly do love being a part of births with!)

A midwife you can trust and feel comfortable with is worth her weight in gold. Birthing a baby is an incredibly personal and intense experience in its own right. Having a professional there to assist you should only offer comfort and help. It’s vital that you find someone that you not only click with, but who you can trust wholeheartedly. Here’s a list of interview questions to start you on your journey to finding your midwife!

A good midwife will be able to speak frankly and to balance your needs/desires with the safety of you and your baby. The midwifery philosophy is generally hands off and more about trusting your body with guidance offered when desired by the mother and medical intervention implemented when required. At the same time, they are extremely engaged with you throughout your care with appointments that usually last one hour and covering not only any physical concerns and questions, but also your emotional state as well. A good book to get you started if you’re new to the idea of hiring a midwife is Ina May’s Guide to Childbirth or watch The Business of Being Born.

Because the system is short staffed in terms of midwives, we are quick to hire one even though they might not align with our birth vision or support we need. This isn’t something we can avoid but trying your best to meet with a few care providers and then asking proper questions is key, otherwise you will be sitting a few months from your estimated due date realizing you didn’t choose the right one, or questioning if this birth plan will be able to happen with said care provider.

So – when you pee on that stick and find out you are pregnant, move quickly to book as many consultations as you can with local midwives to interview them and select the best match. Don’t settle, not with something so important!

Also, just because they have the word midwife in their title, not all midwives are created equal. It’s important to find out what their style of midwifery is. What their beliefs…. but also, what their past births talk about their methods and practice.

Here are my top questions to ask:

Why did you become a midwife? (This is my favorite one! It’s actually the one I love people asking me in terms of why I choose to be a doula in the birth space)

Find out what their draw to this profession was. Many midwives have stories about their first experiences with birth and midwifery and why they felt the pull towards this profession. Learning about where they came from and what brought them here can give your insight into the values and goals your midwife has, and these will definitely influence how she practices within the birth setting and at your birth.

I follow this question up with:

What do you love most about being a Midwife?

This is another question I love getting from potential doula clients when they ask what I love most… and I light up and give my honest and impactful answer to them! Does this answer they provide align with what you are looking for from someone you are adding to your birth team?

What’s your philosophy on pregnancy and childbirth?

Understanding your midwife’s perspective on pregnancy and childbirth determines if their approach aligns with your preferences and values.

What’s your definition of a good birth?

This is a question I love hearing what key words unfold. If they use words like help, fix, medical…. RUN! Birth isn’t medical. You know how to birth your baby. A care provider is merely there to support you as you birth your baby. They don’t fix things, that is a red flag for interventions that don’t need to happen. Listen to how they describe their role in the birth space, or what they see as being a “good birth”.

How do you use informed consent in your practice?

Informed consent is permission granted in the knowledge of the possible consequences. In childbirth it means that everyone receiving maternity care has the necessary support and information to understand the options available to them and the risk and benefits of those options, to enable them to make decisions. One of the biggest factors in whether you remember your birth as positive or negative is the degree to which you feel informed and involved in your decisions. You will remember the experience you have birthing your baby for the rest of your life. The memories around the decisions made will leave lasting physiological and psychological implications for you and your baby. You are the boss of your own birth. By understanding informed consent, you can head into the birth well informed but also ensure the care provider you choose also believes in your ownership of your birth and ability to make your own decisions and by them ensuring informed consent is part of their practice.

I always recommend following up this above question with this next one. Are you comfortable supporting me if I make informed choices outside of the standard guidelines?

For example, if you decline something that is normally recommended such as the vit k shot, how do they support your decision or handle your choices? If you choose not to get vaginal exams/cervical checks during labour how will they handle this choice? If they require these long-winded reasons or justifications tells a lot about a care provider and how they will be responding to your choices in the higher stress busier times in the birth space. You shouldn’t have to explain your decisions, nor should you have a period after it. No need to expand on anything you decide on once you have that space to make an informed choice.

What is your c-section rate? Epidural Rate? Induction rate?

In a time where these numbers are off the charts and literally out of control, it’s important to learn what the rates are at each midwifery practice your interview. Someone who has over 50% c-section rates would be a concern or red flag since they fall even above the already insanely high numbers. Also noting how comfortable they are talking about these interventions and the concern over the overuse of each of them.

A great follow up question to this is:

How are you feeling about our current medical system and some of the concerns like higher c section rates and induction rates?

If the WHO sees the current British Columbia Cesarean rates of over 43% as being high (they recommend anything over 10-15% is a serious concern), what does the midwife you are interviewing think of this? How they respond tells a lot about their views about true physiological birth and unnecessary interventions being used.

What is your home birth rate? What is your home birth transfer rate?

This question goes hand in hand. Since some midwives don’t even do home births anymore. If you want a red flag, then this is a hard no and NEXT in terms of moving on to another care provider who will. Then What is your home birth rate? If they barely do any and you really want one…. why? Dig deeper. Transferring to the hospital can happen. It usually isn’t an emergency. Research shows the overall transfer rate for this ranges from 9-13%. The average rate is usually 10-15% so if the practice you are interviewing has a greater than 20% transfer rate, it may mean this practice is especially conservative and transferring for what reasons? And why? It’s good information to know.

How often do your clients remain pregnant past 42 weeks?

Understanding the midwife’s approach to managing post-term pregnancies and inductions can help you make informed decisions should your pregnancy extend beyond your estimated due date (which is most common)

Your choices for midwives – Lori’s master midwife list. I do not promote or recommend any ONE care provider – I recommend you do your research and INTERVIEW MANY OPTIONS. Just like then people interview for doulas they often select a handful of doulas to chat with in zoom interviews. And then pick the one that aligns with their birth vision and what feels right to them.

Overall, you will go with your gut after these interviews and select the midwifery clinic that aligns most with what you see as your vision for your birth. A good sign would be connection, feelings of excitement, trust, and calm. Uneasiness, trepidation, or uncertainty are good clues that you should continue looking.

When you are thorough with research and questions, your gut feeling can really carry a lot of weight. Trust your judgement.

Happy Birthing!

Lori

LORI’S MASTER MIDWIVES LIST LOWER MAINLAND/FRASER VALLEY

Vancouver

Pomegranate – www.pomegranate-midwives.com/midwifery-intake-form/

Westside (Alma Street) – www.westsidemidwives.com/new-client-intake-form

Pacific – www.pactificmidwiferypractice.ca/intakeform

Strathcona – www.strathconamidwiferycollective.com/intake-form

The Midwifery Group – https://docs.google.com/forms/d/e/1FAIpQLSf3o2O6DXFStzRj-MIzsnZBJ9AXJKFursZUkyuI1iw9e2M18w/viewform

North Vancouver

Canopy – www.canopymidwives.com/intakes