Having a supportive care team is essential to creating a positive birth experience.
In the moment of meeting potential care providers, you may not remember all the questions that you want to ask them. In fact, you may not even know which questions would be the most beneficial for you to ask. Here’s a list of foundational questions that you and your partner can bring with you to each interview.
Interviewing an independent midwife or pair of midwives can be fairly straightforward since she/they can speak for the whole practice. However, if you are considering a hospital birth, be certain to interview care providers and the hospital(s) you are looking into. You can achieve this by calling the hospital and asking to speak to the head nurse in Labor and Delivery. Check in with her about the hospital’s procedures and statistics. You may also check with the Human Resources department to determine statistics. Even if you are planning an out-of-hospital birth, it can be helpful to at least interview the hospital so that you can feel knowledgeable and confident about your back-up plans.
Let’s start with general questions for interviewing any care provider (CP) and then we’ll move into specifics for individuals and families planning natural hospital births and out-of-hospital births.
- What usually happens at prenatal appointments? How many and when? How long is each appointment?
- Are you available by phone or email for questions that arise in between visits?
- What is your philosophy on weight gain, nutrition, exercise, and prenatal supplements?
- What testing do you recommend prenatally and why? Which of these tests are required and which are optional?
- Do you recommend ultrasounds? Under what circumstances? How many and when?
- What do you consider to be a high risk pregnancy? How does your care for individuals with high risk pregnancies differ from care for individuals with low risk pregnancies?
- When is “overdue”? What testing do you recommend/require when the estimated due date has passed? At how many weeks gestation do these tests start and how often do I need to do them?
- What do you think about doulas? Are there any restrictions on the doula I may hire? If yes, why?
- Will you put my birth plan in my file at the hospital so that nurses and your back-up CP will know my preferences?
- Do you use an on-call rotation or do you attend all of your own patients? If there is an on-call rotation, do each of the other CP’s share the same philosophy and approach to birth?
Labor & Birth
- Are cervical checks required or optional? How many/how often do you do them?
- Will I be able to eat and drink during labor?
- What are the routine intervention rates for your practice – IV, AROM (artificial rupture of membranes), continuous monitoring, etc.?
- Will I be required to receive IV fluids or have a hep-lock in place?
- What’s your induction rate? Cesarean rate? Successful VBAC (vaginal birth after cesarean) rate?
- If I choose an epidural, when can I get it and when is too late? (Remember, epidurals are only available in a hospital setting.)
- How often is episiotomy used?
- When would forceps/vacuum be used? Which method are you more comfortable with?
- How comfortable are you with alternative birthing positions? How many of your patients/clients opt to birth in positions other than semi-reclining or lying on their back?
- What is your comfort level with allowing labor and birth to progress without time constraints as long as the birthing individual and baby are doing well?
- Do you deliver breech babies naturally? VBAC’s? Twins?
- How much time do you allow for the birth of the placenta?
Natural Birth in the Hospital
These five questions are adapted from the richly insightful book Natural Hospital Birth by Cynthia Gabriel. In this book, natural birth means “the most instinctive, self-directed, intervention-free birth possible.” Following each question are Gabriel’s recommendations for evaluating the CP’s response.
- Can you tell me what kind of birth you chose for yourself [or what kind your wife chose], and what you learned from it? Remember, caregivers bring all of their personal experience, thoughts, and opinions to a birth, even if they try not to. If a midwife or physician is willing to discuss their births, you will learn a lot. Note their attitude toward their experience.
- Can you tell me about the most recent natural birth you attended? If the person has to think hard, you have just gained valuable info. If they readily describe the most recent inspiring natural birth, you also have valuable insight. If the birth described was quick, ask the caregiver to describe the last long natural labor she attended.
- In your opinion, what helps women achieve natural birth? What can a woman do to prepare? Stumbling for answers means that a practitioner does not often ponder these questions. Their focus is likely on the external, mechanical side of birth. If the practitioner has an immediate opinion that makes sense to you, you might be able to work together. You are looking for someone who believes that what women do in labor matters.
- In your professional opinion, what are the main reasons that women who want natural births do not have them? Answers such as “Birth is unpredicatable. Anything can happen. It doesn’t help to get too attached to the idea of birth going a certain way.” tells you that the practitioner is not very committed to helping women achieve natural birth; they are more concerned that their clients learn to accept medical interventions.
- What do you think birth pain means to women? What is the value of birth pain? Again, notice their overall attitude toward birth and birthing women.
Interviewing Out-of-Hospital Midwives
Most of the questions above are helpful to ask midwives. These additional questions will help you get to know each midwife’s practice even better.
- Who is your back-up midwife and can I meet her?
- Who are your assistants? Will/can I meet them prior to labor?
- How many births do you attend per month?
- What factors would risk me out of your practice? How will you help me prevent these?
- How far can I go past my due date and still birth under your care?
- What type of monitoring do you do during labor? How often and for how long?
- What is your transfer rate?
- What are the reasons I may need to transfer to a hospital setting either during labor or after birth?
- If I transfer to the hospital, will you remain with me through delivery? What about your partner/assistant?
- What postpartum care do you provide? When and where do appointments take place?
How do you feel?
As you interview potential care providers, observe how they respond to you. Do they answer each of your questions thoroughly without seeming annoyed? Notice your level of comfort around each person, and if you feel heard by them. If possible, bring your partner or beloved birth companion with you to each interview. Take into account how they feel about each practitioner. Do you both feel like you can be yourselves around the care provider? Can you both imagine asking him or her anything? Do you feel confident that they would give you a heartfelt response? Can you imagine being naked around them?
Take your time with these interviews. Get to know your options, and enjoy the process!
Photo credits: Danielle Stormes
Last updated: 3/1/18