First, it is important to understand that there are two types of midwives, Certified Nurse Midwives and Lay Midwives. Both have their pros and cons so it is important to weigh these when deciding who want to attend your birth.
A Certified Nurse Midwife is a registered nurse who has a specialized education in midwifery.
A Lay Midwife is a a women who has received training as a professional midwife and has attended many births and is able to care for women before, during, and after birth. It is important to note that, sadly, this practice is not legal in all states, so you must be aware of you states laws.
Midwives are trained solely for the purpose of caring for women in childbirth. This is an important difference between them and obstetricians who are primarily gynecologists and RARELY get to witness a birth free of intervention.
Midwives help women labor and deliver mostly by allowing things to unfold naturally, but are well aware of when to intervene. Because intervention is rare in most midwife assisted deliveries the main responsibilty of midwives is to be a strong support system for the laboring mother.
Just like with any professional that you entrust your care to, it is important that you feel completely comfortable with your choice of midwife.
Here are questions you should ask (taken from Homebirth by Sheila Kitzinger):
-How long have you been a midwife?
-Why did you become a midwife?
-What was your training?
-How many mothers have you delivered, and of these how many were homebirths? in a birth center? in a hospital?
-Do you work alone or with other midwives?
-If you work alone, what happens if two women are in labor at the same time?
-If you work with others, will I be able to meet them?
-What is your backup system? Do you work closely with any doctors?
-What do you carry with you in terms of equipment and supplies? Do you carry drugs, for example, for pain relief and to stimulate the uterus? (only relevant to home/birth center)
-What resuscitation equipment for the baby do you carry? (only relevant to home/birth center)
-What prenatal care do you provide? Are there any home visits?
-Do you offer childbirth classes or pregnancy discussion groups? If not, can you recommend classes?
-What postpartum care do you provide?
- What do you do if a woman has a very long labor?
-What is the plan of action if transfer to a hospital becomes necessary? (only relevant to home/birth center)
- Under what conditions do you transfer? What are your transfer rates? (only relevant to home/birth center)
- If you work with a birth center, are there any standard procedures that must be followed regarding admission and when in labor, such as compulsory fetal monitoring, birth positions, and so on?
- What are your views on routine episiotomy? What is you episiotomy rate?
- How often do your mothers have an intact perineum?
-What happens if perineum requires suturing? Will you do this yourself or call a doctor?
- When are your vacatons? If you plan to go on vacation toward the end of pregnancy or within three weeks of due date, and labor begins, who should I call?
Some other things to ask about would be her beliefs about:
- Fetal monitoring
- Moving during labor
- Birth positions
- Methods to avoid episiotomy
- Basic beliefs about birth
- Basic beliefs about breastfeeding
Remember it is important that you and your midwife mesh well, so discuss your birth plan and what you are hoping for your birth and be sure that you are on the same page.
If you are happy with her answers and you seem to get along well, you have probably found your midwife. Now, you can book her, but you still have to pay her. If she is a Certified Nurse Midwife she is likely covered by insurance, but if she is a Lay Midwife it is imprtant to discuss her fees and payment options.
I really believe that a midwife is the BEST option for your birth attendant. It is just a matter of finding the right one for you. Here are some places for you to start your search: