What to look for in a Midwife in 5 steps

Written by Layne Fernandes

Text and image copyrights to La Dolce Vita Photography by Layne Fernandes.

What is a Midwife?

The term "midwife" is referred to a certified and highly trained professional who supports healthy women with healthy pregnancies, without any type or risks or complications, during labor, delivery and also after childbirth. She can deliver babies in several locations, as: home, clinics, birthing centers and hospitals.

Midwives are not medical doctors. They train to specialize in pregnancy, childbirth, postpartum care, and general women's health. The highest degree a midwife can achieve is a Doctorate in Nursing Practice, DNP.

Based on their training and certification, there are 3 types of midwives: Certified Nurse-Midwife, CNM, Certified Midwife, CM, or Certified Professional Midwife, CPM.

You can also verify credentials through professional organizations such as the American College of Nurse-Midwives.

1. How to select a good midwife?

Finding the best fit midwife is looking for the professional who is both clinically qualified and also a good fit for your preferences during pregnancy, childbirth and also with great knowledge in postpartum care.

The scope of practice varies by location in the U.S. territory; make sure you will be working with an experienced person who has earned one of the degrees mentioned above. The best choice depends on where you hope to give birth and your medical circumstances. These items will help you determine what type of midwife you will be looking for.

During meet and greet consultations with your midwife, please also consider how comfortable and confident you feel about her:

a) Do you feel comfortable discussing sensitive concerns? How natural did she answer to these personal concerns? (Make sure you bring a list of your concerns, so you will won't forget about any item during meetings.)

b) Do you really feel heard and answered thoroughly?

c) Were risks explained clearly?

This relationship and trust are often just as important as the credentials and level of experience of your potential midwife.

2. Where to look for recommendations of a good midwife?

   Personal experiences can provide insights into communication and support quality. You may start collecting data about midwives via friends' referrals or a family member who has recently given birth, your current OB-GYN or primary care clinician, local parenting groups, your local neighborhood group of communication such as next-door, churches may have referrals, doulas and lactation consultants and childbirth educators.

3. What to ask a midwife during meet and greet meeting?

For obvious reasons, it is very important to verify valid credentials of professionals you choose to work with. In this case, when meeting and greeting your potential candidate of becoming your official midwife, make sure you ask and take notes of answers to these questions:

• What type of certification or licenses have your earned? Are you still attending professional development courses as continuing education?

• Are you licensed to work in (say the state where you currently live). in our case here, Colorado?

• How long have you been practicing?

• How many births do you, normally, attend yearly?

• Have you had any difficult birth situation to deal with and what was the outcome?

• How do you deal with anxiety during birth? Anxiety from mom-to-be, father or dealing with surrogate moms, if this is your case.

• What emergency equipment and medications do you carry?

• Can I speak with recent clients?

4. Understanding your Midwife's Practices and Philosophy of Care.

A good midwife should explain options clearly and respectfully while informing and guiding the parent-to-be on decision-making.

Good questions to have in mind, when interviewing your potential midwife's candidate, and learning about her knowledge and option on the following:

a) Do you attend births at home, birth center or hospital?

b) Which hospitals do you have privileges at?

c) What type of set up is required for births at home? How can we sanitize items prior to birth?

d) How are transfers to higher-level care handled?

e) What happens if any type of complications arises and what have been the most common complications? How do you manage to resolve possible complications?

f) Who covers if you become unavailable? Do I have a backup midwife to meet?

g) How can you be reached after hours and holidays?

Do not forget to include in your questionnaire:

a) What are the most safely recommended pain management options?

b) What are your induction policies? How do you handle this procedure at home?

c) What happens if medical intervention, for a Cesarean birth, is needed in the last minute?

d) What is your plan for support for breastfeeding and post partum recovery?

e) Does your midwife work in multicultural level, religions or does she have a group or niche preference?

f) What happens if there is any type of complication to the newborn who needs immediate medical intervention?

5. What to watch out when looking for a midwife.

   After interviewing different midwives and, finally, selecting the best fit for your delivery, it's always very important that BEFORE deciding and closing a contract with your best potential midwife candidate you run the following verifications:

   A) Insurance verification and costs:

   • Clarify any separate hospital or birth-centers charges.

   • Confirm whether they're in-network.

   • Ask about what is included as total fees, how many prenatal visits, how many birth attendance, postpartum care and emergency plans.

B) Red Flags along the interviewing process:

• Is the midwife unwilling to discuss emergency plans?

• Is she discouraging any further medical care or medical intervention?

• Is there any type of pressure about your specific choices or any rush about signing a contract?

• Are you finding difficulties to verify credentials or licensing?

• Does she make any type of promises or guarantees about birth outcomes?

My suggestion

Interview at least 2–3 different midwives before deciding. The strongest predictor of satisfaction is often whether you feel comfortable, respected, and able to communicate openly with the provider, not just credentials alone.

I hope this guide helped you clarify and organize your thoughts and feeling on where to start about considering a midwife to work with natural childbirth plan.

Feel comfortable to reach out for positive suggestions on this list that can help other moms-to-be in search for the best midwife in the Denver area, or anywhere in this "big/small world".

Best of luck!