HOW TO INTERVIEW A MIDWIFE

Background:

Certified Professional Midwife Credential (CPM) - 

- What was her pathway to taking the NARM ? (MEAC school or PEP)

       ***MEAC is an accreditation body for midwifery schools and PEP is a pathway of apprenticeship-only leading up to sitting for the NARM credentialing exam to become a CPM***

- If MEAC, how many births or years of training did she have outside of required births? Did she have any mentorship or a formal residency after graduation?

- If PEP, did she train with more than one midwife? What did she use for the academic portion of her training before sitting for the NARM?

- Does she have protocols or practice guidelines that guide her care? How frequently does she update them?

- Does she offer basic prenatal labwork and ultrasounds if desired by the family?

Certified Nurse Midwife Credential (CNM) -

- How many out-of-hospital births has she attended?

- Of her overall birth numbers, how many has she attended as the primary midwife in the out of hospital setting?

- How is her care different when practicing in hospital vs out of hospital? Is she more conservative in the home setting?

- Who is her collaborating physician and what limitations does her collaborative practice agreement place on care?

Direct Entry Midwife -

- How many years of training has she had?

- How many births has she attended as a student midwife?

- How many births has she attended as the primary midwife?

- How many midwives has she apprenticed with and what are their backgrounds?

- What is her training and experience with birth emergencies and complications?

- Does she offer basic prenatal labwork and ultrasounds if desired by the family?

- Does she have established relationships with high risk OB providers and EMS in the unlikely event of complications?

- Is she NRP (neonatal resuscitation) and CPR certified? Are these certifications current?

Community:

- Is she active in and well-regarded by her local midwifery community?

- Can she provide references from former clients?

- Does she regularly participate in peer review with local midwives?

- Does  she have midwives who are willing to provide back up care in the event that two births are happening at the same time? Who are the midwives and where are they located?

- What is her relationship like with the local medical community? Does she have established working relationships with local hospitals, hospital-based midwives, and OBs in the event her families need higher level care?

- Does she facilitate transfer of care in emergent and non-emergent situations necessitating transfer or is that the family's responsibility?

Financial:

- What is her fee? What is included in her fee? Will there be additional requirements outside of this and how much do those typically cost? (ie supplements, infusions, birth kit, birth tub, etc)

- When in care might a refund or partial refund be appropriate? Are these instances outlined in her signed contract?

- Does she have a financial agreement outlined in her contract?

- Does she require a NDA or any other obligations in order to issue a refund?

- Does she provide a superbill, work with a biller, or offer any client support for obtaining insurance reimbursement?

Practice Model:

- Who attends births with her?

- Is there ever a time when her birth assistant, student, or doula will be caring for you without the midwife's presence?

- Does she have a contract or paperwork outlining what you can expect out of care? What happens if you risk out of care? What happens if you require transfer prenatally or intrapartum, would she go with you to the hospital? 

- What factors might mean that you would risk out of her care?

- Are there any medications, supplements, or therapies that she requires for all or a majority of her clients?

- How many clients does she accept per month? Does she have a limit? How often does she miss the births of clients in care?

- What equipment does she bring to a birth? Ex: Medications for hemorrhage, homeopathy and herbs, IV fluids, oxygen, resuscitation equipment for baby?

- What is her philosophy of care? Why is she a midwife?

- If she is not credentialed and therefore not legally a midwife in the state of Missouri, how does she logistically work around this when providing care? How does it impact her care decisions or the care that she provides?

Experience:

- Does she have any skills or experience related to maternity care that enhance the care she offers? Does she offer any additional services outside of midwifery care?

- Does she participate in continuing education opportunities?

- Has she worked in any settings other than the low volume home birth setting?

- What complications has she encountered as a practicing midwife? Has she ever had to resuscitate a baby? How would she handle a hemorrhage? How would she handle a shoulder dystocia? 

- Has there ever been a time when a family was displeased with her care? How did she handle this experience?