Here are some important questions when you meet with a Private Midwife:
How long have you been a midwife for?
Experience is important, especially when you are employing a private midwife. If a junior midwife may be looking after you, you want to make sure she has a mentor to whom she refers. Midwives need to learn but they should be in a supportive environment when working in Private Midwifery.
Where has your experience mainly been – hospital or community?
A midwife who has worked extensively in the community is used to being independent and forming good networks for support in the community. She/he is not reliant others to make decisions for your care which is often the case in the hospital environment.
How many women do you take per month?
You want to make sure your midwife will be there for you and that she won’t be exhausted trying to juggle births, home and life. The recommended full caseload for a midwife (by the Australian College of Midwives ) is 4 women per month for 10 months of the year.
For homebirths – do you carry emergency drugs, oxygen and suction?
Every homebirth midwife or a midwife caring for you in labour at home should carry this equipment. The emergency drugs are those used in case you bleed following birth. She should also carry IV equipment in case you have a heavy loss requiring emergency fluids till you are transferred to hospital.
Do you work with a second registered health professional in homebirths? If not, who looks after me if you can’t be there?
The reason you are having a homebirth or a private midwife is so that you KNOW your carer. It is well researched that when you know and trust your midwife you are less likely to have any interventions and your labour will be shorter as you feel safe and secure with her/him. It is recommended by the Australian College of Midwives that for safety, a homebirth is attended by a midwife and registered health professional ~ in case of emergency. You also need to know your midwife’s back up person well so you feel safe and trusting with her also.
What skills and preparation do you include in your care/program?
You want to know that your midwife is experienced in “moving and shakin” to shift babies who are mal-positioned, that she/he will teach you breathing and meditation to prepare for birth (preparation of mind, baby and body) and that she refers to a number of health care professionals for optimal care during your pregnancy. You want to ensure your midwife is skilled and experienced with holistic tools and skills in preparation for labour, birth and parenting.
How much time do you spend with me antenatally, postnatally?
You want to feel listened to, supported and special. You want to know your midwife has time for you, for your questions and concerns. You also need to know how many home visits or clinic visits you can expect.
What is your epidural/intervention rate and why?
You are wanting to have a normal birth, that is why you’re seeking a private midwife. You need to know that she/he has statistics over the years that they have a minimal intervention rate and only use interventions when medically indicated, not because she/he is wanting to control or rush things along or simply doesn’t have the experience.
What is your caesarean rate?
This is most commonly asked in relation to an obstetrician, not a midwife but consider this ~ who looks after you in labour? Who’s experience, energy and hopefully intuition is guiding the labour and ensuring safety and ease through this natural physiological process? The midwife! Not the Obstetrician!The Obstetrician is the one who is called in when things have gone wrong and then, when nothing can be done to rectify a situation, then calls for a caesarean.
Since private midwives only look after low risk normal pregnancies, her/his outcome should be less than 3% ending in caesarean.
Who do you refer to when there is a medical concern?
You need to know whether you are going to be referred to a GP, Obstetrician or into the hospital so that you can be part of the decision as to where to go, who you would feel comfortable with. You need to know your midwife has an established referral system supporting her/his practice.