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How to Interview a Homebirth Midwife

10/11/2016

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​ I have shared with you all that we are expecting our 6th baby.  It was with baby #4 that I began looking into using a midwife but it wasn't until baby #5 that I was able to convince hubby to get on board with a home birth.  In my state (as in many in the country) this can be a bit tricky.  Where I live if you hold professional certification of any sort you cannot attend a homebirth as a midwife.  What that means for me is that I have to locate a midwife who is skilled in her trade, has medical training, clinical skills and is flying under the radar.  Other states are different and for a mom planning a homebirth it requires a bit of self-education.  

When an expectant mama is new to this whole realm she is often confused about who to ask for advice, how to interview a midwife and what to ask.  I have been there myself and it was a sheer stroke of luck that I found an amazing midwife with my first interview.  If I had been in the position of having to interview a few different ones, it might have been trickier.  There are questions you should definitely know the answers to, there are things you should be observing, all of this comes with experience but I am going to attempt to take some of the mystery out of it.

First and foremost you need to identify your own philosophy on birth.  Do you want someone who takes control while you ride shotgun and tells you what to do and how to do it?  This is typically the stance of most OB/GYN professionals so you may be perfectly comfortable seeking out an OB who practices with midwives in a birthing center type of environment.

Do you want a midwife who walks alongside you offering suggestions but allowing you to hold the reins?

Do you want a very hands off midwife or one who is more hands on?

Do you want a midwife who performs physical exams (I am not referring to your belly girls) or one who does not?

Do you want a midwife who welcomes the assistant of a doula, or one who works alone?

There are so many things to consider so the first step might be brainstorming what your perfect birth would look like for you and then ensuring that you discuss that when you are interviewing a midwife.

Once you have located a midwife (or a few) to interview pay close attention to how she makes you feel.  

Do you feel warm and safe in her presence? 

 Is this the kind of person you could imagine being friends with?

How does she respond to your other family members and what kind of a sense do they get about her?

You also need to be asking what her hospital transfer rate is and what types of situations she feels would necessitate a transfer.

In addition, there are some pretty standard things that most midwives avoid you need to think about how you feel about them also.  This might include things like onset of labor prior to 37 weeks, certain high risk factors for your health (I’m old, that’s a “risk factor” in typical OB practices, but that is not what I am referring to).  Multiple prior C- sections, etc.

Cost is of course also a factor you should be asking about as well as post natal care.  In addition to these questions, you will have some of your own to ask, I even pulled together a quick printable sheet  you can use to really help stay organized.  Use it to record notes, feelings and interview a few midwives before you settle on the one you want to attend your birth.
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Where do you find these midwives?  Start with a Google search of Midwives in....(whatever state you live in).  Look on facebook, there are HUGE homebirth groups you can join with members all over the US and abroad.  I like this one on facebook called "Homebirth & Waterbirth." ask around and ask moms why they liked a particular midwife.

Now that you are well versed in what to ask, go get organized and start interviewing.  Want a great resource to use?  I've pulled together a great interview sheet for you to use, it is totally free for you to print when you subscribe to blog updates (you know all the crunchy mama stuff).  This is a 3 page printable with space for notes and midwife specific information.  Simply use a binder, hole punch and you are organized!  For a copy of the free printable just sign up here:

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Related Posts:
CHOICES IN CHILDBIRTH,
5 WAYS TO INCREASE YOUR CHANCES OF A NATURAL CHILDBIRTH
​5 REASONS TO CHOOSE A MIDWIFE OVER A TRADITIONAL OB
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My homebirth story...

11/14/2014

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If you missed the previous posts, here is Part I, and here is Part II.  Now for the continuation:

So there we were creeping on on the final stretch.  This baby would be born at home, that was our plan.  I followed all of my midwife’s recommendations and really enjoyed the prenatal care she provided, it was more like visiting with a very experienced friend who offered suggestions and advice but who listened intently and seemed as excited about the birth of this baby as I was!  I dutifully ordered all the supplies my midwife recommended, I began an herbal birth tincture that I had taken with the last pregnancy, and I contacted the county to request my “out of institution” birth certificate paperwork.  I had all the bases covered. Well, almost all.  We chose not to tell our families for fear of their reaction to our decision to have a homebirth.  We just figured, we would let them no later, and after all they could just come to our house to meet the new baby!

For those who may not know, a homebirth has to be completely non-medicated.  Midwives are not doctors and do not prescribe medications.  If there appears to be any serious complications it is the job of the midwife to be monitoring to be sure that as signs arise they will be corrected or if not, a transfer to a hospital may be required.  Midwives are trained for many different situations including VBAC, breech presentation, and even a baby’s cord being wrapped around its neck.  The midwife acts as a guardian to ensure that the natural process of birth progresses as it should and they watch for any concerning signs while nature runs its course.

The winter was in full swing and it was bitterly cold.  Every night that I went to bed with the random contractions I was feeling, I became increasingly at peace with the fact that whatever time this baby did decide to come, we wouldn’t have to venture out into the wicked cold.  However, I was becoming anxious, this was a waiting game.  I believed with all my heart that this baby would make an appearance around a week or so before my due date, after all, this was baby #5 and my last birth came at 39 weeks.  So, as one can imagine, when 39 weeks came and went, I was becoming more and more impatient.  My midwife was not at all concerned (very unlike what I was used to with an OB who usually by 38-39 weeks began suggesting an induction).  My midwife just shrugged and said, “He will come when he is good and ready.”  I asked all kinds of questions and did further research and realized that dates are not exact and that the baby would be just fine until even as late as 42 weeks (something today’s doctors would not usually allow).  My midwife just said “Trust the designer, and his design, the baby will be ready and come when the time is right.”

 I lay down to sleep one night; sleep was such a joke by that point as uncomfortably huge as I was.  I woke in the middle of the night (a normal occurrence) but when I got up to make my frequent trip to the bathroom, I kind of wondered if my water had broken (I know by this time I should have no trouble figuring that out but I am here to say, I was unsure) I laid back down and looked out the window.  It was about 7 degrees and the snow was coming down so hard I could no longer see the barn.  There was already 2 feet of snow on the ground and it just kept coming.  I really didn’t want to call my midwife with a false alarm in this kind of weather, and it was 1am.  I tried to go back to sleep.  The contractions I was having at this point were frequent and had been for about 2 weeks at this point, but I could still talk through them, so I knew it was not imminent.  My husband rolled over and I told him what was going on, he said I should probably call the midwife, but again, I didn’t want to inconvenience anyone in what surely was another blizzard outside.  By 2am I had decided that my contractions were definitely picking up.  So, I did decide to call.  I actually had to set the phone down briefly during a contraction while talking with my midwife and she said she would come on over and that if it was a false alarm, no big deal, she would just sleep on the couch until morning.  (That made me feel better).  I also called my friend, the doula. (funny story, her husband had just come in from shoveling out the driveway, he said he just had a feeling that tonight was going to be the night).

It was within about 10 minutes of that phone call to the midwife and the subsequent one to my doula that things started picking up, and fast.  Before anyone could even arrive I was in my “zone”, the “don’t talk to me during a contraction” zone.  The contractions were coming as hard and fast as the snowflakes were outside, but I was in my home, it was warm, and I was not stressed out. 

My husband must have been getting things ready but I think I was oblivious.  We put a very large, kind of noisy, fan in the hallway outside of our bedroom and shut all of the children’s doors.  The children knew what our plans were and they had been told that if they woke in the night and their doors were shut that they should just wait until daddy came to get them so they could meet their new brother.  I remember all of a sudden feeling an intense wave of nausea (I later figured that was my transition phase) and when the midwife arrived I was hanging my head in the toilet (lovely huh?)  But, I do remember that I still had a sense of humor and in the 1-2 minutes between contractions we would laugh about something but then I wanted silence when I was going through the intense contractions.  My doula was there, reassuring me and helping me to focus on breathing (I have a tendency to hold my breath during pain) and my midwife was there talking calmly and in soothing tones as well.

 I remember feeling like I needed to use the restroom one last time, but once I got to the bathroom I became paralyzed with pain.  The contractions were so hard and fast at that point that when my husband and midwife told me to just climb into the tub and let hot water run over me, I couldn’t even lift a leg to get into the tub, I just could not move.  It was then that my husband essentially let me put almost all my weight on him and he did the walking for me to get me back to the bed.  No sooner did I make it that far (it was less than 10 steps) then the baby decided now it was time to come into this world.  I remember not feeling any panic or stress, I just was ready for this part to be over, I believe I may have yelled out at this point , (okay maybe a lot) but it was so fast and then, my newest baby was here.  I FELT AMAZING!  As soon as he was born all of the pain was gone and it was like this intense wave of adrenaline and excitement as well as exhaustion washed over me all at once. I saw him and he was HUGE!  I fully expected the midwife to do everything that the doctors and nurses did, but she just stepped back and let me enjoy this new little person that I was meeting face to face for the first time.  It was almost like time stood still. 

Our baby was not crying and this worried my husband, but our midwife explained that was very common for homebirth babies, there was no stress, no bright lights, no one tearing him away from mama to suction and wipe and all the other stuff.  Our new baby looked at me in kind of a groggy just woken up from a nap kind of way and he blinked.  We decided to allow the baby to have a delayed cord clamp. This basically means that when the umbilical cord stops pulsing blood from the placenta to baby, that is when it is clamped, not immediately on the doctor’s time.  This allows the baby to get all of the oxygen rich blood from mom and allows for a less rushed atmosphere.  My baby nursed and then just looked around at his new world. 

My midwife had things cleaned up in the time it took me to walk to the bathroom.  I wanted a quick shower so my husband held the baby while I took a hot shower, in my own home.  That was priceless.  I wrapped up in my favorite robe and sat down to nurse my newest baby.  He was 9lbs and at least 8 oz. 

It was now about 4 am (remember this all started at 2am so yes, it was FAST) There was a very faint tapping on the bedroom door and when my husband opened it my two daughters were there, so excited to meet their baby brother.  Shortly thereafter my 8 year old son joined us and a bit after that my toddler awoke.  We all were piled in my bed (yes it was all clean and looked just like my room did any other time) and enjoying one and other’s company.  My husband went downstairs to start a hearty farms-style breakfast and my midwife kept vigil while my doula and my kids and I chatted.  It was almost magical because of the peace of it all.  It was still snowing outside and I later learned that the drive was a bit treacherous for both my doula and my midwife.  It was beautiful for me though, I was cozy and warm in my home, with my new baby in my arms.  I felt like if I could do this, I could do anything!  I wish that every mother could know this kind of amazing empowerment that comes from being surrounded by other women who are there to support you, comfort you, and if needed, intervene.  I felt that this was the best birth story I had yet and I felt amazing.

This picture was the one we texted to all of our friends and family, he was 5 hours old here.

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It was by far the best birth experience I have ever had.  It was the most peaceful, happiest, least stressful and most amazing thing to come to the realization that our bodies are perfectly capable of doing exactly what God designed them to do, and without medical interventions.
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Our Homebirth Story...PART II

11/6/2014

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My first post is here...This is the continuation of the story...

We had another baby on the way.  This was baby #5 for our family.  I had just left my full time career as a social worker and we were so excited.  We waited until 12 weeks in to share our happy news and Christmas had just come and gone.  That is when we learned that baby was not meant to meet us this side of heaven.  I share this part of the story for a few reasons, one, I again was bent towards the more natural way of proceeding.  I experienced bleeding on a Sunday morning and was very concerned so I went to the ER.  It was there among cold lights and hard shiny floors that we learned the news, the awful news, our baby was gone and there was no little flickering heart beat on the monitor.  My doctor was out of town and when contacted advised that she wanted me to undergo a D&C.  I did not want any procedure done as I wanted things to proceed naturally (I had been through this kind of loss before).  My doctor reluctantly agreed to allow this, while on the phone with me from vacation several states away. 

We went home then to grieve, and to heal.  A week went by and that’s when my body decided that it was time, I had time to process things a bit better by then and emotionally that made it slightly better.  However, when my body began the process of purging and healing it went a bit too fast and I began to hemorrhage.  My husband is a nurse and was immediately concerned (more than I) so he rushed me to the ER.  I was stabilized, but not without a seed of fear planted so deep in my husband that he wasn’t even sure he wanted any more children.  He was convinced he almost lost me.  I again avoided a D&C but had to be almost obscenely adamant at the hospital because, that was just routine for them.  But, it wasn’t routine for me and I did not want to undergo that procedure.  I was discharged hours later after a period of lengthy observation.  Time to go home, and finish healing.

I was quite unsure if after my body had time to heal, whether God would bless us with another baby or not.  I was so happy to have my 4 healthy children but my heart was grieved still for the loss of our baby.  It was about 3 months later that I became pregnant again.  I was scared that I would also experience another loss but I just prayed. And prayed.  I prayed for a healthy baby, a healthy me, and most of all for God’s peace for whatever was to come.  The pregnancy progressed very normally and after we got to about 18 weeks along I approached the subject of home birthing with my husband.  I had loved the last medication free birth but I wanted to welcome this new one without the nurses, the IV fluids, the bright lights…

The conversation did not go very far as my husband pretty much shut it down immediately.  He was fearful as it had just been about 7 months prior we were in the ER with him being convinced I was not going to make it.  I reminded him that all of our babies were born without any major issues, I had never had any reason for concern and had never had any trouble healing.  I prayed then.  A few days later I mentioned to him that a woman we both knew of (and knew of fondly) was also a homebirth midwife, a fact he did not know.  I would imagine I wore him down because shortly thereafter he agreed that I could just call and talk to the local midwife we knew of.

I called her.  I loved her immediately.  She was down to earth, willing to help, and held many of our values dear.  She did not think my medical history was a concern and felt based on the information I provided to her, that I would likely to great having a baby at home.  She suggested my husband and I watch a documentary called “The Business of Being Born” that was on Netflix.  I told her my husband was a hard sell and she said she was not in the business of persuading husbands but she would agree to come meet us both.  She mentioned that sometimes that sets people more at ease.  I got him to watch the documentary; it was very eye opening for both of us.  I wanted this to be our birth experience.  Our baby was also due in February (key likelihood for very bad weather) and my labors are intensely fast, we both had feared having the baby in the car when I was in labor with baby #4.

 I asked him to allow me to invite the midwife over, just to meet us.  I was still seeing my OB and we were due for our complete fetal scan ultrasound in a few days.  He agreed.  She came.  We talked.  She visited with us for almost 3 hours and when she left, we shut the door.  My husband then turned to me and said “that’s not fair, I really like her.” 

I proceeded to go to my ultrasound appointment with my regular OB so that we could see if our baby looked healthy and if things looked as though they were continuing to progress normally.  The ultrasound showed a perfectly formed, healthy looking baby who appeared right on target.  It was after this appointment that, with my husband’s blessing, I began seeing our midwife.  She came to our home for prenatals and was very involved in a holistic approach to the birth.  She included my children in our appointments by letting them use the Doppler on my belly to hear their new sibling’s heartbeat.  It was amazing and it gave us the opportunity to really get to know one and other.  My OB appointments lasted about 15-20 minutes.  My midwife appointments were more like chatting with an old friend, we would have a cup of tea and our visits could easily surpass an hour and a half because we would get carried away talking.  Go time was not too far ahead…(to be continued)

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Our Homebirth Story...Part I

11/3/2014

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     I have always been a natural kind of girl.  Trying natural methods for things before moving into more invasive.  I like herbal remedies, I love not jumping to modern medicine for everything.  I look back and realize that I took this approach in almost every area of my life, with the exception of the birth of my babies.  I saw an OB/GYN who happened to become a good friend of mine over the years.  We even had babies born within a day of one and other which meant we were in the hospital at the same time!  I trusted my OB/GYN and her judgment so when she suggested with my first child that I have an induction (baby would be pretty big, of course) I said okay. 

     When I planned for a natural non-medicated birth, that became almost an impossibility with all the interventions being done to me and the lack of ability to get up and move around…not to mention all I had ever heard was how horrible the pain was and that of course I would want to ask for an epidural before it was “too late.”

     I did end up with an epidural as most women who have been induced can tell you, it is not a natural pain and it is pretty awful.  But, I had my beautiful baby girl.  I just did not have an optimum birth story to go with her entrance into this world.

   Baby #2 went much the same, since I had some difficulties with baby #1 (she was born head and elbow at the same time…4th degree if you know what that means) my doctor again suggested an induction because of course we did not want a repeat of the first birth experience.  I again gave in, and though again I tried to go without an epidural…it was kinda hopeless.  This time I had some undesirable effects from the epidural, I had nausea and vomiting as well as a persistent lower back pinch pain that lasted well into 3-4 months post partum.  But here was another beautiful baby.

  Baby #3 and by this point I had kinda given up on the idea of natural birth.  I was checked in for another induction (after all it was 5 days before Christmas!) and I just decided to give in to the inevitable and have my epidural…only this time…it didn’t work.  My left foot was numb- but that was it.  It didn’t seem that anyone believed me at first and I was not prepared mentally for a natural birth so I kind of went in to panic mode.  But, this baby was not waiting, and was ready to be born.  The anesthesiologist only had time to remove the tubing from my spine but not even run another line of medication because this baby was almost there!  So, amid a bit of a freak out moment on my part, this little one was born…and I felt it ALL!  AAAAAHHHHH. But, I learned something that day.  I wasn’t going to die from the pain.  The pain was over immediately after his birth, and I was able to get up and walk around immediately after.  I liked that last part.  My body didn’t have some of the same effects of medications as previously…hmmm….

   Another interesting thing is that all of my babies had been born jaundiced to the point of having to have bililights and much stressful daily heel pricks to test for jaundice levels in the blood.  They were all also induced at what the calendar read as 37-38 weeks along.  NOTE: babies born prematurely are at a much higher risk for jaundice.  (I don’t mean as in preemie babies, mine were all size wise over 7lbs but may not have been full term as dates are not perfect)

   When we became pregnant with baby #4 a friend of mine was just deciding that she wanted to become a doula.  I wasn’t completely hip on what that meant but since she needed hours attending births to help with her certification she said she would love to attend my birth and be a support.  Okay, sounded good.  This time I was determined, no meds, no induction…I was going to have this baby au natural.  Did I mention my doula had her last baby at home?  Now that idea was just crazy! Right?  My doula was amazing.  She gave me this book to read (and cautioned me that it was a bit wild, and not written from a Christian standpoint) but I dove in, it was one of Ina May Gaskin’s works…about midwifery.  Hmmmm…. The thought of a homebirth was a seed planted.  I mentioned it to hubby this new idea...but he suggested I had lost my mind.

     I worked throughout this 4th pregnancy, and it was a very stressful time, so when we got close to the end I was very impressionable and was almost at the point of giving in to my doctor’s suggestions of inducing again.  But, I had a very supportive doula who cautioned against that modality because; it is pretty unnatural and very painful for a mama who is trying to do this on her own.  Then the time came, and this birth was VERY fast.  When I say fast, I mean we checked into the hospital and he was born within 20 minutes, Very FAST.  But, it was drug free and AWESOME!!!  My doula was a HUGE help, and I felt so high on adrenaline afterwards and so empowered.  My body was amazing and could do amazing things, as was every female body.  My baby was also not jaundiced and not born until 39 weeks.  He was healthy, he was perfect and he was a big boy! 8lbs 11oz!

   So, when I revisited how that birth went…how much more I trusted my body to do what it was designed to do, and how much better I felt afterwards, it seemed a natural progression to at least explore what home birthing was all about.  I had read about it, I now had at least 3 friends who had amazing experiences with home birthing, and I knew of a local midwife…(to be continued)

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    Wife to a wonderful husband, Daughter of the King, Mother of 6 (one with an xtra chromosome), and an incidental farm girl.

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