SO YOU’VE DEBATED BETWEEN having a Midwife or ObGyn and have decided that you want a more personal labour experience with someone you feel comfortable with.
You are a low-risk pregnancy, so you have a perfect candidate for a midwife.
You decide on a midwife but you don’t know where to start.
Depending on where you live, you might not be so fortunate to have a choice, as midwives are limited in the number of births they can physically attend. However, if you do have the opportunity to interview a couple, these following tips are key.
Not only is your primary midwife the person you will have to trust and call on during the most difficult times of your labour, but she is also the one who will be making the call if any emergency arises.
So making sure you feel comfortable with their training, experience and personality will be important, as well as their abilities to perform emergency procedures if necessary.
So as soon as you find out your are pregnant (and you’ve done a little dance), it’s time to book your midwife!
Below are the 5 Steps to Choosing the Right Midwife for You.
1. Where’s your catchment?
So the first thing you need to do is submit a “request care” or “intake form” to midwife centers in your catchment.
Each clinic can only travel a certain distance from their center, but also from the hospital where emergency care would be provided. So research your state or provincial midwifery association to see which clinics are within your catchment.
2. Book an appointment
Hopefully soon after you’ve sent in the “request care” form you will receive a call from the midwives’ center about availability. They will book you a first appointment, usually at the end of your first trimester, or tell you that you’re on a waiting list.
So before you go to your appointment you will likely want to get some blood work with your family doctor, a physical exam and perhaps book a dating ultrasound for after your 7 week timeline.
In the blood work you’ll be looking for some or all of these factors:
- Ferritin levels
- B12 levels
- vitamin D levels
- Thyroid function
- Liver funtion
- Blood glucose (fasting so come on an empty stomach)
- hCG (just to confirm the pregnancy)
- Sexually transmitted diseases (ie. Chlamydia, Gonorrhea, HIV, etc.)
Eventually you will be tested for Group B Strept (GBS) and Rh factor, but that typically happens later on in the pregnancy.
3. Questions… lots of questions
So the first appointment with your primary midwife is to really get to know each other and test the waters. You want to feel comfortable with her but also get the answers to any burning questions your have.
The appointment will start off with a general education about midwifery and what they can offer that is the same or different than an ObGyn or family physician.
Afterwards, these are common questions to ask:
- What they think of home birth
- How comfortable they are with homebirths
- If they have any research to make an informed decision
- About their birthing experiences
- How many home and hospital births have they done
- Any difficult birth they experienced and how they handled it
- If they ever have had a mom or baby die under their care
- Where the associated hospital was
- Who are the secondary and back-up midwives
- Any books, resources, or classes they could recommend
4. A question that is not commonly asked
This weekend I was with a group of friends, of which 2 of them recently had an unexpected birthing experience. They had a planned home birth that ended up in hospital. One had a walking epidural and empowering vaginal birth, while the other went on an intervention roller coaster and ended up with a c-section.
The main difference in their experiences was how the midwives were trained and what they were able to do in hospital.
I had no idea there was a difference.
So one recommendation that I was given when choosing a midwife is to ask:
If the midwives are allowed to continue being the primary care physician after an epidurals (or walking epidurals) is administered in hospital, if the situation arises.
Some hospitals transfer care to the ObGyn once an epidural is required, while others still allow the midwives to maintain full control of the delivery AND administer the epidural.
This is something that you might not think about if you are planning to have a home-birth, but as my friends experienced, this isn’t always the case and so you want to mentally prepared for any emergency steps that will follow.
It’s all about trust. If you have faith in the skills and recommendations of your midwife and the midwife team, you will be more confident and relaxed in your labour. This is a magical time to empower your body to deliver your baby, the last thing you want is doubt, worry, fear or anxiety to overwhelm you.
So no matter what kind of physician you decide upon, make sure you (and your partner) are comfortable that they will be competent in delivering your new born into this world.
In another article, I will get my colleague Dr. Michelle Peris, ND to tell me all the things you need to know that your Obstetrician AND midwife doesn’t ask you!
Till then, happy planning and good luck with finding the right midwife for you!