How to Evaluate a Good Home Birth Midwife

I am always asked by other woman if I can recommend a good home birth midwife to them. I have been blessed with very good midwives. I am so grateful for the home birth midwives that have attended my 8 births. My midwives have been some of most influential women in my life and I am forever grateful for their wisdom and incredible care they have provided me over the years of birthing at home.

I have heard horror stories from other women about their disappointments in not being able to find a good midwife. As a prospective client, you need to evaluated the prospective midwife carefully to see if your expectations for birth will match how the midwife practices.

No two midwives are alike, just like no two doctors practice exactly alike. Home birth midwives are not the same type of midwives that work at a hospital. CNM midwives could be called “medwives”. I like CNM midwives, but after working with some of them as a doula in a hospital setting, I can tell you that hospital midwives are just really different than a home birth midwife. Don’t expect a CNM midwife to practice like a home birth midwife. They are usually considerably more medical in their approach.

Home birth midwives are different. There are lay midwives and CPM (certified professional midwife) midwives that deliver at home. However, within the group of home birth midwives, there are vast differences in home birth midwives and how they practice. You must first meet with the prospective midwife and see if she might be a match for your family.

Everyone is different and my opinion of what a good midwife is, may be entirely differnt to someone else. Some women may prefer their midwife just show up during labor and bake cookies for them while she labors in the other room by herself. Other women prefer having a midwife that is actively involved in helping her get through hard labor contractions through making eye contact, following breathing, verbally encouraging her and applying hot compresses through the labor contractions.

Here is my “good midwife” list which is my opinion of what I think a good midwife is:

A good midwife will require an interview or meeting with you and your husband before she takes you on as a client. She will want to meet you and your family and want to discuss what you are wanting in regards to your birth. You should want to interview her as well. The first interview between you and the midwife should consist of a lot of asking questions.

A good midwife will talk to you and your husband about her education, her training and certifications if any, her experiences and an overview of how she practices. From this, you should be able to know if she is a “hands off” midwife or a “hands on” midwife. You will need to match what you are wanting to how she practices. Many women looking to give birth at home are looking for a midwife that isn’t overly medical in her approach.

A good midwife will assess your risk factors prior to accepting your as her client. She will be able to tell you if you are a good candidate for home birth and if not, she will tell you why and give you advice on how you can go about having the kind of birth you are looking for.

A good midwife will send you to the hospital when medically necessary. A good midwife isn’t opposed to using doctors and hospitals when necessary.

A good midwife has back up plans in case of an emergency.

A good midwife will be able to tell you what medical concerns or emergencies she transports for.

A good midwife will regularly schedule prenatal appointments with you and will be able to tell you what her prenatal appointment routine is: blood pressure check, weight check, fundal height check, baby heart beat check, checking on your prenatal nutrition and asking you if you have any questions.

A good midwife keeps good medical records. Your midwife should be filling in information on your chart at every prenatal appointment. If anything comes up, you will have a good prenatal record from which to refer.

A good midwife helps you maintain a low risk pregnancy. Good prenatal nutrition and proper pregnancy exercise is essential for maintaining a healthy pregnancy and for preparing for a healthy birth. A good midwife should be talking a lot about good prenatal nutrition.

A good midwife has a good knowledge about herbal medicine. Natural herbal medicine is a wonderful gift! Herbs can be used safely during pregnancy and labor and your midwife should know what herbs are useful and beneficial during pregnancy and labor.

A good midwife is knowledgable. She should be able to answer all your prenatal and natural childbirth questions or be able to get back with you to give you an answer. When issues do arise during pregnancy, such as low iron or low protein intake, your midwife should be able to give you valuable suggestions and resources for treating these issues

A good midwife is a good teacher. Look for a midwife who is knowledgeable about holistic pregnancy, the natural birth process, healthy postpartum period and successful breastfeeding. She is willing and able to teach and train you in these areas.

A good midwife is ready and available. When she can not be available (she’s already at another birth, for example), she has backup resources that will be able to care for you or that will be there for you incase you have questions.

A good midwife is a good labor coach. While your husband should be the primary labor coach, helping and assisting you through childbirth, your midwife should be there actively involved with the birthing process. This doesn’t mean the midwife is standing over you at all times, but she does know what is going on and is aware of your stages of labor. Depending on your desires, a midwife can be a very vital lifeline of help during hard labor contractions, transition labor and pushing labor.

A good midwife offers suggestions for labor positions, encourages walking and frequent change of positions, encourages eating and drinking when necessary.

A good midwife encourages your husband and supports him as the head of your family and the one responsible for you and your baby.

A good midwife actively helps first time moms during the pushing stage of labor. The pushing stage of labor catches many first time moms by surprise. A good midwife should prepare you for the stages of labor. You should feel free to ask her questions about labor and what you should expect. She should guide you through transition and help you through the hard labor contractions, help you with your breathing, and guide your pushing so you do not tear. Many moms tear simply because someone was not actively guiding them through with when to push, when to hold, when to breathe and when to stop. Discuss the pushing stage of labor with your midwife!

A good midwife is equipped to deal with things like excessive bleeding, stitches for tearing, oxygen and CPR.

A good midwife, after the baby is born, makes sure you are doing well and the baby is doing well and has latched on and is nursing well.

A good midwife gives you detailed postpartum instructions about what you can expect.

A good midwife helps first time moms with breastfeeding and doesn’t assume…”she’ll figure it out”. Usually, first time moms are very unfamiliar with breastfeeding and need some help and encouragement. It is great to have a midwife, a mom or sisters who can stay with you and make sure the baby is well established with nursing. You need to have someone you can call on to help you. Most breastfeeding problems are because of lack of support or from lack of asking for help. New breastfeeding moms should not feel bad for asking for help. New breastfeeding moms should be aware that breastfeeding a baby is a very natural and normal thing to do, but it can take some time to get use to it and know what to do. Ask for help!

A good midwife checks on the postpartum mom. You should be having a postpartum appointment with your midwife soon after the birth. Some midwives schedule several postpartum appointments just to make sure everything is going well: the bleeding is within normal rage, your uterus is shrinking, no fever, breastfeeding is going well and your milk is established, the baby’s weight is good and other health issues are addressed, such as jaundice, normal stools etc.

A good midwife is a treasure. If you find a good midwife, be very grateful for her and tell her how much you appreciate her!

If you need a help in finding a good midwife or other natural pregnancy / birth providers: doulas, lactation consultants: You can search here.

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