By Anjelica, MSM, CPM, CLEC, LM.One of the beautiful things about midwifery care is that it centers the needs and desires of the mother. Midwifery and the Midwives Model of Care™ is unique in that it places value on things like:
- Individualizing patient education, counseling and prenatal care.
- Providing continual hands-on assistance during labor, delivery, and postpartum.
- Minimizing the use of interventions.
THE MIDWIVES MODEL OF CARE, 2022
This means that midwives are looking to better understand you in order to provide you with care that aligns with your values, culture, and lifestyle. Many soon-to-be mothers and their partners find this philosophy refreshing and in-line with how they view pregnancy and birth, as a normal part of their life instead of an entirely medical event.
Depending on whether you plan to utilize the services of a hospital-based group midwifery practice with multiple midwives, or a solo homebirth provider, with one primary midwife attending all the births, you’ll want to ask some questions in advance to help make a decision about whom to choose.
QUESTIONS TO CONSIDER:
How many clients do you take per month and will you be the midwife at my birth?
This is a particularly useful question when interviewing a solo or duo-homebirth midwifery practice, since you’ll want to know how likely it is that your birth may coincide with another, and if so, who will be the back-up midwife to care for you, in case it’s possible to meet them ahead of time. If you’re seeing midwives who are a part of a group practice, you’ll want to know if it’s possible for you to select your preferred midwife who will attend your birth.
What is your transfer rate and most common reasons for transfer?
For those planning a homebirth, this can help you better understand the chances of you needing to transfer to the hospital. You’ll want to ask about some of the most common reasons for transfer as well in order to have an accurate idea of what to expect. Oftentimes, first time moms transfer more than those having a subsequent birth.
What is the hospital’s C-section rate?
Even if you find a midwife that you really jive with and who supports your goals for a vaginal birth, if they deliver at a hospital or practice with colleagues that don’t also support those ideals, you may be more likely to end up with unexpected interventions that lead to a Cesarean birth. This is particularly important for those seeking a vaginal birth after Cesarean (VBAC), those who want to wait for labor to begin spontaneously as opposed to having an induction of labor, specifically if you go beyond your due date, and those who’d like the freedom to move about in labor and during pushing. For those aiming for a VBAC, you may also want to ask about their “VBAC success” rate.
What pain relief options do you support?
Depending on how you envision your birth, you’ll want to know what the range of pain relief options are.
These may include:
- A birth tub - either one you’ve purchased and set up, or a communal one that requires reservation at your local hospital or birthing center.
- Nitrous oxide – an inhaled gas, which may be available at some free-standing birth centers and hospitals.
- A TENS unit – a compact device that uses electric pulses to moderate discomfort.
- Acupuncture – this requires a trained person to come to your home or hospital room, some hospitals have one on staff, while some people hire their own beforehand to come to their home or birth suite.
- Narcotic medications – primarily offered in hospital settings and provides limited pain relief.
- Epidural anesthesia – a type of anesthesia administered in your back, which may limit movement but provides a great deal of pain relief.
If you’re wondering when to bring these questions up, I recommend doing so at the beginning of care or even before your first appointment, if possible. For private midwifery practices with a single midwife, you will likely need to call their office and schedule a private meeting with the midwife where she will answer your questions. For hospital-based midwifery groups there is sometimes a specific day each month where families are invited to come in and “meet the midwives” all together and have their questions answered. Not only are these meetings good for having your questions answered, but also evaluating how they answer the questions, which gives you an idea of their personality and temperament, two important pieces to choosing the right midwife for you.