Finding Your Perfect Midwife:
6 Tips on How to Choose
Finding your perfect midwife is a very personal and intimate decision. The period of pregnancy, labor and delivery is usually filled with strong emotions and concerns, particularly when you have chosen to give birth outside a typical hospital setting. In addition, there are different types of midwives which we will describe below.
Your ideal midwife will be an expert at navigating this incredible emotional journey while providing expert care in the way that works best for you, your baby, and your family.
Remind Me: Exactly What is a Midwife?
The literal translation of the word 'midwife' is 'women with' or 'with woman.' A midwife is a person (male or female) who attends to the pregnancy care of women who prefer a low-intervention birth.
While there is no rule that requires a midwife to be female, the vast majority of them are. So with complete respect to ALL people who are 'with woman' through her pregnancy, we will refer to both certified nurse-midwives and licensed midwives as 'she' and 'her.'
With all that in mind, here are six essential factors to help you choose your perfect midwife:
1. Ensure She is Properly Qualified
A good first step in finding your perfect midwife is to ensure she holds at least one credential from a reputable certification and / or licensing body. The North American Registry of Midwives (NARM) issues the Certified Professional Midwife (CPM) credential, which is established through training, education, supervised clinical experience and a written exam.
Here in California the Licensed Midwife (LM) designation is administered by the California Medical Board and enables the recipient to provide a broad range of women's health services to expecting mamas, including prenatal care, childbirth, and newborn care.
In the United States a Certified Nurse Midwife (CNM) is an individual who has received her Registered Nurse (RN) license, attended an approved graduate program from an institution accredited by the American College of Nurse-Midwives and passed a certification exam administered by the Accreditation Commission for Midwifery Education (ACME).
2. Insist on Experience
When it comes to midwifery care (yes, that’s a word!) - experience matters. Every birth is different and your perfect midwife is most likely the one who has ‘seen it all’ – for both high-risk pregnancies and low-risk pregnancies - and can respond calmly and confidently to any situation.
Regardless of whether she is an licensed midwife or a certified nurse-midwife, ask her how many births she has attended, what beliefs she has formed about medical care and what lessons she has learned. Find out whether she prefers holistic care and her level of experience with home birth and water birth. Understand her perspective on medical interventions such as cesarean section; when are they necessary?
Consider asking whether she has had a natural childbirth experience of her own. While that is not a prerequisite to being a good midwife, wouldn’t you prefer to entrust your care to somebody who has ‘been there, done that’ herself?
3. Make Sure You are Comfortable With the Birth Plan
While there are many similarities, licensed midwives and certified nurse midwives sometimes have differing perspectives on the care of pregnant women. Generally a licensed midwife will be oriented toward a low-intervention, out of hospital (OOH) birth, while a certified nurse midwife might be a good idea if you preference is for a hospital birth.
Regardless of her credentials, every midwife has her own approach, ideally developed over years of experience. Be sure you talk with your potential midwife about the flow of prenatal visits, labor and delivery, and postpartum care. Make sure you are clear on how long visits will be, what will occur at each visit, and whether any tests or screenings are required. Find out how accessible your midwife will be between visits if you have questions or concerns.
Be sure to understand her point of view on pain relief and pain management. Most midwives will propose a complete birth plan before labor commences. Finding your perfect midwife includes agreeing to a plan that fits your personal desires and preferences.
4. Pay Attention to What Others Are Saying
The single best way to find your perfect midwife is to start with referrals from people you know and trust. There’s nothing quite like a personal referral and / or a glowing public reputation to help put an expectant mother’s mind at ease. If you can, talk with other new mothers who are willing to share the childbirth experience they had with your prospective midwife. Search for her under Google and Yelp reviews.
Ask her for references. Don’t be worried about a negative review or two – every midwife will have a few of those, especially if she has been practicing over many years. When considering potential midwives, do make sure that others have had the kind of experience you desire, under the care of your prospective midwife.
5. Don't Assume "Insurance Will Pay"
The unfortunate truth is – some insurance plans do pay for midwifery care and an out of hospital birth, some don’t. Ask your potential midwife whether she accepts insurance and what her experience has been achieving reimbursement. Make sure you check with your plan administrator before engaging with a midwife, to avoid unpleasant surprises.
If you are committed to an OOH birth and your insurance plan won’t cover it, ask your potential midwife about discounts and payment plans. Most will work with you to realize your goal of a natural birth experience.
6. Trust Your Gut In Finding Your Perfect Midwife
This person will be an important part of your life for weeks or months to come. How do you feel in her presence? Does she inspire feelings of safety and confidence? Do you enjoy her at a personal level? Do you trust her with your emotional and physical well-being?
In our practice, we believe the most important step, by far, is to find the right fit - we call it finding "your perfect midwife." And we know it won’t always be one of us. Your childbirth needs are as unique as the rest of you. Make it your top priority to find your midwife. That will go further than anything else to ensuring you have the natural birth experience you want.
What's Next?
If you are looking for your perfect midwife, you have probably made the decision to have a natural birth. If so - congratulations are in order! You've made a decision that will change your life in a very powerful way! I know that's dramatic, but I've had hundreds of mamas tell me that is exactly what happened for them.
If you would like more detailed information on the process of natural birth, I invite you to check out my article on the one thing I believe ALL natural birth mamas should do, regardless of care setting: Birthing Classes for Natural Birth.
