Choosing a midwife

Midwives have a wide variety of practice styles. Choosing the right one for you may present some unique challenges. Where you birth goes hand in hand with the person with whom you choose to birth. The first decision is whether you want a home, birth center, or hospital birth. The trend toward midwife-assisted birth is growing in America. Certified nurse midwives, or certified midwives in some states, have hospital privileges. They practice in hospitals or birth centers and can do home births. Non-nurse or direct entry midwives only do home births. I recommend that you interview all primary care practitioners before you decide to hire one of them. Make a list of questions to ask and set up an initial visit. Most will give you a one-hour free consultation.
Most people elect to have hospital births, so we will discuss this option first. Looking in the phone book or asking your insurance company if they list midwives is a good place to start. You can also ask your family or friends if they know of or have used a midwife. One way to learn if there are any midwives practicing at your local hospitals is to call the labor and delivery wards and ask the nurse managers. They will know if any midwives have hospital privileges at their facilities. They may also be a good source of information regarding practice styles. You may have to travel a distance to find the person you want to work with. Many first-time parents make the mistake of thinking they need to be ten minutes from the hospital.
While hospital-based midwives are generally nonintervention-oriented, you cannot simply assume that you will get the kind of birth you are looking for. You must carefully screen midwives by asking direct questions related to the way they practice. What kind of procedures do they use during a usual birth? Some midwives have a very intervention-oriented philosophy. If your goal is to have a natural childbirth or avoid unnecessary interventions, you need to fully inform yourself about what questions to ask. Remember that midwives must follow the rules of the hospital where they practice.
Some hospitals have special rooms on the labor and delivery floor called an Alternative Birth Center. These rooms are generally more relaxed than the regular labor ward. They read more