What questions should I ask prospective midwife helping with home birth?

[SuzanneSays]

Hi, this is our first pregnancy and for various reasons (live abroad and healthcare for labour pretty old fashioned) we would like a home birth, in a birthing pool if possible. Can anyone advise what interview questions we should ask to help us choose a midwife?

[Iggly]

I assume you mean a private midwife?

Choosing a midwife was very much personal for me. We went with someone who seemed confident and we got on with.

I didn't treat it as an interview - more a chat about why we were going for an independent midwife, my pregnancy so far, her experiences etc.

[whereisshe]

A home birth midwife should be experienced in managing a birth without the back up of a hospital or other HCPs. I gather from my home birth midwives that it's very much a personality thing (they were all "strong" personalities, completely lovely but tough mentally), but also years of experience is vital as you will be completely reliant on the midwife to decide if a transfer to hospital is warranted if a problem happens.

So I would ask:
How many home births have they officiated at
What is their role during the birth, and what are they able to do for you at home both routine and emergency (differs by country eg in the UK you can have pethidine but not all home birth midwives will give it, and they can't prescribe it in advance. Also home birth midwives carry resuscitation equipment and can stitch minor tears)
What is their transfer rate (to hospital) and how does it compare to the national average
If there is anything you particularly want for your birth, how would they support that
What antenatal care they provide, and what postnatal care they provide

But most of all, you need to feel that you get along with them.

[SuzanneSays]

Thanks whereisshe that is very helpful. We live in quite a remote area, though can get to the hospital in about half an hour in an emergency. My main concern is if there is a problem, will there be enough time for me and baby to get to hospital.

[whereisshe]

The vast majority of hospital transfers for home births are for failure to progress, so rarely a time-critical emergency. And even for an "emergency" c-section (emergency just means unplanned, crash means do it now), the time from decision to surgery can be half an hour in hospital anyway - they can ring ahead and prepare for surgery if needed so the transfer time isn't wasted if you see what I mean. Also if you are in active labour in the UK they would always blue light you to hospital as a matter of course, but check what the policy is where you are. It's probably worth finding out what pain relief options are standard in ambulances where you are, eg do they all carry entonox?

This site was very helpful when I was planning my home birth. I also highly recommend Ina May Gaskin's books and also Nicole Croft's good birth companion - they should give you an idea of what a normal natural birth entails and hence a better sense of what is "right" vs what is "wrong". I found it helpful to know that I could trust my own feelings about what to do (positions, how to labour, when to ask for help etc).