Homemaking · October 30 · 8 min read
How to Choose a Midwife
The letters after her name matter, and so does the bag she carries. Hire the midwife who will tell you when the plan has to change.
This is how our household cooks, washes, and thinks. It is not medical advice, and it is not a substitute for a midwife or a doctor.
This is not medical advice. These are thoughts from our own experience.
A midwife is not a preference. She is the person who will decide, with you, whether this labor is still safe outside a hospital. Choose her the way you would choose someone to watch a child who cannot speak yet. Warmth is good. Skill is the point.
The letters
A certified nurse-midwife is a nurse with graduate training in midwifery. She can practice in a hospital, a birth center, or a home, depending on the state and on the practice. A certified professional midwife is trained for out-of-hospital birth. A licensed midwife is a state license, and the rules change when you cross a state line. Ask which of these she holds, and what that license allows where you live. A woman who calls herself a midwife and holds no license and no certification is asking you to be her backup system. This page does not recommend that.
Unassisted birth, with no trained person in the room, is a different decision from a home birth. It leaves bleeding, a stuck shoulder, and a baby who needs a first breath without the hands that are trained for them. We will not dress that up as the natural ideal.
Questions that are not small talk
- How many births have you attended as the midwife, not as the helper?
- What share of your first-time mothers transfer? What share of mothers who have already given birth?
- Which hospital do you transfer to, and have you met the people who receive your clients?
- Do you carry medicine for bleeding after birth, and a bag and mask for the baby?
- Are you current on newborn resuscitation?
- What do you do if my group B strep test is positive?
- What is your plan if I am still pregnant at 41 weeks, and at 42?
- Who comes if you are at another birth?
- How many postpartum visits, and do you watch the baby's weight and color, not only mine?
Listen for a person who can describe a transfer without scorn for the hospital. A midwife who speaks as if doctors are the enemy will hesitate on the night you need one. You want the midwife who is calm about physiology and specific about complications. If she promises you will not tear, will not transfer, and will not need a single medicine, she is selling a mood. Birth does not owe you that mood.
