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Questions For A Midwife....

Forum: Natural Childbirth


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November 26th, 2010, 09:22 PM
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Hello ladies.
My DH and I are planning to TTC baby #5 next year. On 12-6 we have an appointment to meet a midwife. I've had 4 babies in 4 different hospitals and all were such horrible nightmares I swear this baby will NOT be born in a hospital unless there is an emergency and we go by ambulance.
Now, I know how to interview a doctor to find out if our personalities match up and what kind of credentials I'm looking for. But what on earth do I ask a midwife? I don't know how they handle things. Home births aren't exactly legal for midwives here. I did speak to this one on the phone for a few minutes before making the appointment.
How are things handled like birth certificates and so on? What do I need to know about my midwife to be confident of her compitance since Georgia has no certification for them?

I'm scared of a home birth. Not as scared of a hospital birth obviously. My biggest fear is the pain. I've been through this 4 times, I know what I'm in for. I know that with #4, I tried my birth ball and the bath tub and I still hurt so bad I was crying for meds. How can I handle this at home?

We plan to TTC in September for a summer of 2012 baby, so I've got plenty of time to mentally prepare myself for this. I'm looking forward to all of it but the pain. I was hoping I could find a CD to listen to to calm me, or even something like guided imagery to get me through it, but I can't really find anything.

Basically, even though this is baby #5, I need advise as if this were baby #1. Help!!!

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November 26th, 2010, 10:41 PM
PixieQueen's Avatar Hi-Tech Hippie
Join Date: Sep 2006
Location: Richland, WA
Posts: 6,038
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Hi Fox!

The guided CDs you are looking for are either Hypnobabies or Hypnobirthing. As far as what to ask, ask what you just asked us, pretty much.

Credentials - CNMs are Certified Nurse Midwives, which means they became midwives through nursing. CPMs - Certified Professional Midwives are direct entery and are trained and certified through a midwifery college. Lay midwives usually train under another midwife, but have no formal schooling. They may have credentials given them in a different state, even if Georgia doesn't recognize it.

Most midwives do prenatal appts, just like an OB, but usually they are less invasive and more relaxed. And one-on-one. My appts were usually about an hour. Only 10 minutes were check-up. Then we chatted. Ask her to describe a birth to you. Ask her what she provides and what you will need to provide. Usually after the birth they weigh and measure baby, hang out for a few hours after the birth to keep an eye on you and clean up, plus cook a meal for you. Even though we had to transfer, when I got home, everything was cleaned up and my midwife's partner had made me post-partum tea. Most do 24 hr, 3 day and 6 wk pp check-ups. Since it isn't legal in your state, you'll probably have to file for the birth certificate yourself. In WA midwives and homebirths are legal, so my midwife did it for me. Check out the homebirth board and the sticky up above for lots of articles that may help answer your questions or give you questions to ask your MW.

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November 26th, 2010, 11:32 PM
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Just at a glance, what do you think of how they describe themselves?
Birthing Way:: Homebirth Midwifery in Georgia
I think I'm looking forward most to the bath AFTER the baby with all the flowers in it! lol The one I spoke to sounded nice, and they both look nice.

I will look for hypnobabies.

What do you think of having things around as something to focus on? I was thinking that in addition to candles around my bath tub I would put some crystals and angel figures.
Tanzanite Diamond Crystal Paperweight - New Age & Spiritual Gifts at Pyramid Collection
Rose Quartz Pocket Angel - New Age & Spiritual Gifts at Pyramid Collection
You know, just as something pretty to look at? Or is that beyond nerdy and superstitious?

And, is Enya's music good for during labor? Some of her songs seem really hypnotic but I don't recall anyone ever mentioning listening to her stuff in labor.

I'm so sorry for all the questions. lol I'll try to not be TOO much of a pest over the next year and a half while I gear up for this.
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November 27th, 2010, 12:18 AM
Sk8ermaiden's Avatar Platinum Supermommy
Join Date: Mar 2008
Location: Houston, TX
Posts: 5,791
Hokay! Here is my giganto list. I don't actually ask all of these. Usually if you ask one, the midwife ends up answering 3 or 4.

What is included in the fees?
What will I need to provide?
Is it possible to pay you entirely next year? (So we didn't have to pay our deductible twice)
What happens with fees if my care is transferred to an OB?

How many births have you attended?
What are your expectations of clients during pregnancy?
Can you recommend or will you loan to us appropriate book, videos, internet sites, etc. to help us prepare for homebirth?
Do you require or recommend that my husband and I take a childbirth education class?
How do you feel about ________ method? (We did Bradley, but I learned my midwife didn't really "believe in" the hypnobirthing, so if I wanted to do that, I'd be glad to know she might not be so supportive of it.)
What do your checkups consist of?
Do you come to my home any time before I go into labor?
What prenatal tests do you recommend?
How do you feel about induction?
How far past dates are you comfortable with me going, and what happens if I hit that limit?
If I develop a condition that makes me high risk, do you have a doctor you normally use to transfer my care to? Do you also try to use this doctor for transfers during labor?
What is your cut-off for considering a baby to be premature and requiring a hospital birth?
What are your feelings on GD? Refusing testing?
Do you deliver breech babies?
What do you do to try to turn a breech baby?
How long do you allow a woman to go with her water broken?

General Labor
How many internal checks do you normally perform?
At what point in my labor will you or your assistant come to my home?
How many clients do you have due in any 4 week period
What do you perceive your role to be during my labor?
What are your expectations of clients during birth?
What equipment and supplies do you bring to a birth? (You are looking for oxygen, pitocen, methergine (sp?), suture materials, mine brings IV fluids so she doesn't have to transfer for dehydration, and also IV antibiotics in case it looks like a GBS+ mom will have to transfer.)
What natural pain relief techniques do you find to be most effective?
What is your usual approach to a labor that is progressing slowly?
How often do you listen to baby during labor?
Do you break the water for any reason?
How much time do you allow for the delivery of the placenta?
What happens if my perineum needs stitching/suturing?
Do you help with cleanup?
How long do you stay after the birth?
Do you have any problems with delayed clamping/cutting?

Potential Problems
Do you have guidelines or restrictions about who can give birth at home?
What is your definition of "high-risk"?
What problems or complications in pregnancy would mean that a physician would become my primary maternity caregiver?
How would you handle a hemorrhage?
What is your episiotomy rate?
How do you handle/have you handled dystoxia/cord prolapse?
What is your hospital transfer rate?
Under what circumstances do you transfer to hospital?
What would be the plan of action if a transfer to hospital were necessary?
What care would you give me if I need to transfer?
What is your Cesarean rate? What are the most common reasons?
Would you stay with me in the hospital? In the operating room? For how long after the birth?

Do you come to see me after I give birth?
What do these visits include?
Will I visit you after the birth? How Often? What do these visits include?
Do you examine the baby at any or all of your visits?
What does the examination include?

Obviously to can add or subtract things that are/aren't important to you. If midwifes are illegal/alegal you really need to talk seriously about how transfers are handled and whether certain meds are available to her.

Last edited by Sk8ermaiden; November 27th, 2010 at 12:21 AM.
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November 27th, 2010, 05:34 AM
HappyHippy's Avatar Platinum Supermommy
Join Date: Dec 2008
Location: Pavia, Italy
Posts: 5,959
Here is a list you can print that is questions for a Midwife and pretty much covers everything.

There are a few different forms of Midwifery.
CNM- Went to nursing school, worked in L&D for atleast a year, and then did the 1 year Midwifery program afterwords.

CPM- Certified Professional Midwife. There is no formal training for this, you can go to college for it, but many do an apprenticship and then take the test when they're done. It does not requrie a college degree or college courses.

DEM- Direct-Entry Midwife. It's like the CPM but there are college DEM programs. Usually the Midwife will be called a LDEM which is a licensed Direct Entry Midwife.

TM- Traditional Midwife, means they were trained through apprenticship.

LM- Licensed Midwife, means they're licensed through their state but may have or many not have took any college courses.

From my experience the pain is when you're in transition, which means you're almost done. The contractions prior to that shouldn't be painful, but some women will find them painful. Transition can last from 15 minutes to a few hours. With my homebirth it lasted 2 hours and then I went to pushing. During those 2 hours was when I cried and doubted myself, but that's normal for transition.
Mama to G, L & twins F & M
Started off 2013 homebirthing suprise twins Fia Celesta & Maddalena Isabella
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November 27th, 2010, 11:35 AM
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I'm going to print off all those questions. Most of them never even crossed my mind!
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November 27th, 2010, 04:23 PM
PixieQueen's Avatar Hi-Tech Hippie
Join Date: Sep 2006
Location: Richland, WA
Posts: 6,038
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Anything you want to do that will make you more comfortable, do it! That's one of the awesome things about a homebirth! You may want to make several types of music lists. I preferred an instrumental type CD while I was in labor. But I know one lady on the HB board had her son to Megadeath. You never know what you'll want or need while in labor until you get there. I thought with my first that I'd get hungry during labor, so DH went to the store and bought a ton of food. I didn't eat any of it. Some people prefer quiet, but I enjoyed chatting during my labor. Plus if you do Hypnobabies, I think they recommend a focal point. Not sure though, as I haven't used it.

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