Considering Home Birth? What to Ask Your Midwife
If you're considering a home birth, the first step is finding a midwife to oversee your care. Interviewing the potential candidates is critical to finding an experienced, qualified midwife who you feel comfortable with. Here are four questions to get your started.
Under what circumstances would you advise against a home birth?
While home birth is a very safe option for many people, it's not right for everyone. Whether or not staying home is an option for you, though, largely depends on your midwife. A problem with one of the baby's organs or preterm labor may rule out a home birth, but multiples or a breech baby may be acceptable depending on your midwife's experience and your personal level of comfort.
What's your transfer rate, criteria, and process?
While no one wants to think about what can go wrong, the truth is that something can go wrong in any birth, no matter where you are. When interviewing a potential midwife, ask what her transfer rate is, under what circumstances she thinks a transfer is necessary, and what the process will be. You'll also want to know if your midwife has hospital privileges — which depends on her qualifications and state laws — or knows of a home-birth-friendly doctor who can pave the way in the event of a transfer.
Who are your backup midwives and where are they located?
Birth is unpredictable. The night my youngest came into the world, it was a full moon with a lunar eclipse on a winter solstice. Just an hour after the midwife arrived, she got a call that another mother was in labor. I was doing fine, and the other mother was known for big babies and quick labors, so my midwife left to go attend that birth, planning to come back and find me still in labor when she was done. Instead, I got hit with a monster contraction 15 minutes after she left, and my midwife ended up having to call a backup from the other birth. The backup midwife arrived just in time to catch and greeted me with “You don't know me, but I'm going to help you have this baby.” My entire response was “Great, can I push now?” Moral of the story: Find out how many backup midwives anyone you're interviewing has, how far away they are, and if you can meet them beforehand.
When should I call you?
You've probably heard of the 5-1-1 rule for determining you're in labor: contractions are 5 minutes apart, are 1 minute long, and have been coming for at least an hour. However, this is set up for a hospital situation, where you come into labor and delivery to a staff of nurses and a doctor who's already at the hospital. Midwives often want you to call as soon as you think you're in labor. This could be in the morning when you've had some bloody show or when you've had contractions stronger than Braxton-Hicks but that aren't coming in any pattern.