Midwife basics

So recently we've started telling people we're expecting baby #5. Ok, actually we just told our kids. And they told the rest of the world.  "Mom, I accidentally told my whole class today.  I couldn't help it!" That's what my oldest daughter told me a day or two after we spilled the news to them.  So if you're just hearing that we're expecting and you are our good friends, don't be offended that at least half the elementary school already knows. So, anyhoo, everyone and their dog knows.  And I haven't even had my first midwife appointment yet.

When you see a midwife, you typically have your first appointment between 10-12 weeks.  The reason being is that at 10 weeks, you can hear your baby's heartbeat with a Doppler (that thing they put on your belly to listen).  No gross vaginal ultrasound necessary, thank you.  Normally I don't want the whole world knowing I'm preggo before my first appointment- what if something's wrong? But, you know, if something was wrong, I'd need the compassion of all those people- I wouldn't want or be able to suffer in silence.

We recently moved to a new city.  So, good-bye to my old midwife (who delivered my other two homebirth babies and was one of my most favorite people ever), time to search for a new midwife.  In our new town, homebirth isn't quite as prevalent as it was in our old, so there wasn't a whole lot of word of mouth references for midwives.  But you just need to know where to look.  There is usually some sort of birthing network in most metro and suburban areas, so I started by getting on Facebook and searching for a local birthing group.  Check. Found one.  Then I posted on their page, asking about local midwives.  They replied, giving me four or five names.  Then I got online and searched, finding each of their business webpages and started perusing.  Midwives are professionals, they are educated, they are running businesses, and any midwife worth hiring will have a website about them, what they do, and their services.  Every midwife I've every encountered also will meet with you for an initial consultation (for free) so you can see if you want to use them.  They realize that you are hiring them.  They work for you.  You are paying them.

The midwife I chose I haven't met yet, though. I did send her an email in which I asked her a few basics: does she service where I live, what is her fee, and how many births does she do per month (she limits herself to 3-4 a month.  That's good.  You don't want a midwife doing 10 births a month.  Odds are good she'll miss yours).  She responded super quick (a good sign), and I went ahead and made an appointment.  Which is in 3 days.  So I'm excited to meet her.  If I wasn't so lazy I'd have gone for the free consultation, but...I am lazy. And if I don't feel comfortable with her, I can go elsewhere, I'm not locked in.
Other good questions to ask a prospect midwife: 

• What is your hospital transfer rate? 
•  5-10% is good. The national overall hospital transfer rate for homebirths is 12%.
• What OB/GYN's do you have a good working relationship with? 
• Good midwives will have good relationships with doctors.  Doctors will know them and respect them.  If your midwife has a negative opinion about doctors and doesn't have a good working relationship with any, that is a red flag. From time to time, a low-risk pregnancy will develop into a high-risk one. You may have your own OB/GYN you'd want to transfer care to, or you may want to continue with a doctor who respects your midwife and will continue to allow her to be part of your care.
• Who are your apprentices? 
• Most midwives will have at least one, if not several apprentices who are learning the trade. This is good. It shows that people want to work with your midwife; she must be knowledgeable and respected.  
• What other midwives do you work with?
• Midwives cover for each other; if there are births that are overlapping or some sort of something happens and your midwife can't come, she will have an agreement in place with other area midwives. 
• What difficult situations have you encountered? Breech, twins, etc... 
• Are you comfortable with a water birth? 
• How many babies have you delivered?
• Have you ever missed a birth?
• Can I bring my kids to appointments?
• Most midwives are fine with this, some even encourage it.  Prenatal appointments can definitely be a family affair. 
• What's your favorite food? 
• Just kidding. But it is great to feel like this woman who will be caring for you and helping you birth your baby is your friend.  A very, very smart friend. 

Keep in mind I am not some midwife/homebirth expert.  Everything I write in this blog is strictly based on my own past and present experiences as a patient.  If you're a midwife or a doula and I have something totally, red-faced wrong, comment and let me know! Who doesn't like to learn something new?

Next post: 

What happens at prenatal appointments with a midwife?