Update and questions Meeting with a home-birth midwife

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stercry's picture
Joined: 08/15/06
Posts: 450
Update and questions Meeting with a home-birth midwife

My DH and I are meeting with a home-birth midwife on Tuesday and I would love some suggested questions to ask.If we go forward with this it will be our first home-birth, I'm getting excited about it. My last baby was completely med free in the hospital and it was a great experience. Thanks!

*Update*
So dh and i met her today and we both really liked her, she seemed very knowledgeable in birth and has over 38 years of experience. however i have a few questions.
number 1 being that she is not licensed, she said that she has chosen not to be because she thinks the state keeps track of them (midwifes) and tries to get rid of them then. I'm not sure how I feel about that. She still has all the equipment like oxygen and pit shots and those sort of things and she brings you all the stuff for a birth cert and SS cards.
number 2, she takes on more risky moms, like VBACs, twins and breech. I tend to er on the side of caution, so that makes me worry that she would push my limits of being comfortable if something were to go wrong. However she lives very close to me, like 15 mins away, and we have an awesome ambulance service here that is free. But the hospital is about 45 min away.

Right now I'm on the fence. My hospital experiences have been good. And I really like my OB, he is really awesome about letting me do my own thing. But getting last minute child care is going to be a pain in the but if I were to have a hospital birth. If I have a home birth, my kids could stay home with us. However I have no family support for a home birth, my parents would try scare tactics. If they knew I was looking into this they would freak.
I always worry about that what-if situation.

Does anyone have a good resource on home birth laws in WA state? I'm having a hard time finding anything useful.

advice, guidance and opinions would be great.

thanks

TiggersMommy's picture
Joined: 02/14/10
Posts: 6043

I'd ask things like:

Does she have a tub you can rent?
When are you cleared for your HB and when/for what reasons might you risk out?
Does she have an assistant? Can she recommend a doula (if you're interested in one)?
Does she *require* that you have additional people there to care for your other children?
Is she experienced in homeopathics (if you're interested)?
When does she start introducing gentle inductions and what sort of things does she often recommend?
What is her transfer rate and for what reasons do her clients transfer?
Is she familiar with hypnosis methods?
How many other clients does she have for your birth month?
Does she have any vacations scheduled anywhere near your EDD?
How far does she live from you?

More than anything, I'd feel out whether or not you like her and would feel comfortable with her. You can always ask her questions over the phone later.

Hope that helps!

cactuswren's picture
Joined: 10/19/09
Posts: 4658

:wavehello:

Hi Crystal! I think Erin's suggestions pretty much cover anything I can think of, but I just wanted to say I'm happy to see you're here and planning a homebirth!

Spacers's picture
Joined: 12/29/03
Posts: 4099

I'd also ask about her experience billing insurance, and specifically *my* insurance company. Does she help with paperwork & coding for you to get reimbursement? What is her refund policy if you get risked out of homebirth?

And does she work with an OB or do you have to have your own backup OB? For what kinds of things would she require OB consultation? If you do need to transfer, does she go with you? Does she have privileges at that hospital to continue your care, or would she be a support person only?

stercry's picture
Joined: 08/15/06
Posts: 450

Thanks for the great questions, I'm going to write all of those down.

Winky_the_HouseElf's picture
Joined: 02/10/02
Posts: 292

Navel Gazing Midwife wrote an excellent series of posts about interviewing a home birth midwife. This is the first post:

http://navelgazingmidwife.squarespace.com/navelgazing-midwife-blog/2011/10/8/interviewing-a-homebirth-midwife-part-1.html

stercry's picture
Joined: 08/15/06
Posts: 450

Update at top

Spacers's picture
Joined: 12/29/03
Posts: 4099

#2 doesn't really bother me. Many of us consider twins, breech, and VBAC to be variations of the norm, not a risk in & of themselves. I applaud her for taking on those moms who believe in their bodies more than in a medical model that labels them as "high risk" whether they really are or not. I know that lots of women in California are being forced to birth in a hospital only because they are pregnant with twins, or their baby is breech even if it's the best breech position possible, only because licensed midwives can't knowingly deliver those babies at home. It was one of the concessions that midwives made to gain licensure. No decent midwife would ever push you beyond your comfort zone because it's ridiculous, you need to be comfortable for a safe, healthy birth, and doing anything beyond your expressed consent could open her to criminal negligence charges.

#1 doesn't really bother me, especially if it gives her the freedom to do #2. However, if she doesn't have a license in a state that licenses midwives, it might be difficult or impossible for you to bill your insurance. In most states that legalize midwifery, insurance companies are required to provide reimbursement if the caregiver is licensed by the state. My only concern would be that poor outcomes can't be tracked if the midwife isn't licensed, so perhaps that's the reason she hasn't done it? Also, if there is a poor outcome for you, there's no way for the state to sanction her beyond any criminal liability. Basically, if you get a good vibe with her and if her references check out, then the lack of licensure wouldn't bother me. I'd probably pay the $7 for a quick internet background check, though.

TiggersMommy's picture
Joined: 02/14/10
Posts: 6043

I don't think #2 would bother me and #1 would only bother me if I felt she were truly avoiding licensing for the reasons Spacers mentioned. My MIL was an unlicensed MW and never under any circumstances would I have let her attend my birth (or anyone else's if she'd still been practicing when I met her for that matter). Personally, I'd call around to other MWs and find out what the norm is for licensing. The MW community tends to be a tight knit one. They might be able to give you a hint as to why she's avoiding licensing and either soothe your fears or send you searching for a new MW. No MW in their right mind would advise a mom-to-be to use a MW who has a bad reputation. Though, I wouldn't put it past a MW to badmouth another MW so as to scoop her clients. If you explain to the other MWs that you like this MW and how close she is to your house but you have reservations about her not being licensed, I bet any half decent MW would give you the honest inside info.

cactuswren's picture
Joined: 10/19/09
Posts: 4658

That's good advice...I might also add that you could try asking other NCB-adjacent people who might have good insight based on experience, for example if there are any Hypnobirthing instructors or doulas around. Those people may be able to give you some good insight without as much incentive to promote their own services, if that makes sense. I know my Hypnobirthing instructor told the group at large (when someone asked) that she knew all the homebirth midwives in town and that most were just fine but there was one she absolutely would not recommend, and if anyone had reason to know more about that they were welcome to contact her privately and she'd share her experience.

Spacers's picture
Joined: 12/29/03
Posts: 4099

I thought of something else. It seems like some of the smaller, more rural communities in places like Washington tend to attract people who are... how to say this politely?... not fond of authority figures? Conspiracy theorists? My mom moved up there a couple of years ago to a small community and when she mentioned that she gets a federal pension (someone asked what she does for a living) she was declared by several of her new neighbors to be a spy or a snitch or something equally notorious. So perhaps this midwife serves such a community where being licensed might be seen as being a government pawn who is going to report the pot plant in your kitchen or the kids' dirty faces.

Also, I'm curious where & how she gets Pitocin if she's not licensed? It's a prescription drug.

TiggersMommy's picture
Joined: 02/14/10
Posts: 6043

"Spacers" wrote:

So perhaps this midwife serves such a community where being licensed might be seen as being a government pawn who is going to report the pot plant in your kitchen or the kids' dirty faces.

Or she herself is a conspiracy theorist. Like my wacko MIL ....

Her reasoning could be entirely valid or it could be a red flag.

ETA:
Just thought of something else. Just ask her what it means for you that she's unlicensed. Her answer might be quite telling.

stercry's picture
Joined: 08/15/06
Posts: 450

Thanks for the input, I'm going to have my DH read all of this and write her an email to ask questions. He is much better at wording things than me. He is also an RN and understands all the licence stuff better than I do.

Spacers I never thought of it being a local or WA thing but yeah I know a lot of conspiracy theorist type people who live in this area. Lol I have lived here my whole life so I guess it is just something I took for granted.

I heard of this midwife threw a few women at my Church who love her and have used her services.

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