Monday, October 24, 2011

Interview Questions for Midwives (or any Care provider)

I found this list someone posted on a Homebirth forum on babycenter.com. One of the most complete and well thought out lists I have seen! I did edit it a little. Posting it as a resource to anyone interested. If there are any other questions you can think of, please post in the comments!

General
How many births have you attended total, and in this area?
What is your transfer rate? Typical reasons for these?
What is your episiotomy rate? Reasons for doing them?
Are you available for phone calls 24 hours a day for advice/emergencies?
What happens if I go past 42 weeks?
What are your experiences with/opinions of Bradley? Hypnobabies/hypnobirthing?
Do you encourage your clients to write birth plans? What is the intended benefit of them?
Would you ever attend twin births? Singleton breech births?
Do you have birthtubs for use or rental? 
 
Prenatal Care
What are your expectations of clients during pregnancy?
Do you perform/recommend a pre- or postnatal Pap smear?
What are your normal guidelines for weight gain?
What prenatal tests/monitering do you recommend/perform
routinely? (BP, weight, urinalysis, ultrasound?)
Do you suggest testing for GBS, and if I’m GBS+, what do you suggest?
Do you suggest testing for GD, and if I fail the glucose tolerance test, what do you suggest?
What are your standards for preeclampsia? How do you manage this condition?
Do you use a Doppler or fetoscope at prenatal visits? How often?
Have you ever had clients with partial/complete placenta previa? How was this detected? How rare are these conditions? How was this dealt with?
When or if vaginal checks are required? Can I request to not have them? What about during labor? How often do you normally perform them and can I choose not to have them?

Labor
What are your expectations of clients during birth?
What supplies do I need to provide for the birth? Where can I purchase those supplies?
At what point after labor has commenced do you prefer I call you, and at what point in my labor will you and/or your assistant come to my home? How many assistants do you normally bring to the birth?
How many clients do you have due in any 4 week period, and what is the plan if I go into labor while you're with another laboring client?
Have you ever missed the birth of a client? If so, what were the circumstances?
What equipment do you normally bring to the birth (birthing stool? oxygen? ambu-bag? pitocin shot?)
Are you okay with my child being present at the birth?
How long do you let things go after ROM (rupture of membranes), if there is little/no progress but the mother doesn’t want to transfer?
Would you be okay with mostly being in another room, if I wanted to labor and/or deliver alone or only with my husband in the room?
 
First/second stage
What do you perceive your role to be during my labor? During labor, how active are you in checking the mom and the fetal heartbeat, etc?
Under what conditions would you perform AROM (artificial rupture of membranes) or otherwise induce or augment labor?
What natural comfort techniques do you provide?
What pharmaceuticals, homeopathics and/or herbs do you use at births?
What is your usual approach to a labor that is progressing slowly?
How many/few people are you comfortable with being present at the labor and birth?
How do you deal with shoulder dystocia?
How do you deal with cord prolapse?
What percentage of your clients tear, and how badly? How do you try to prevent this?
How long are you willing to let a client push, or do you base it solely on the baby's stress level?
How do you think the pushing stage should be managed?
If I or my husband wish to catch the baby, are you comfortable with me/him doing so?
What positions do your clients most often give birth in? What positions do you prefer, and why?

Third stage
How soon do you like to clamp and cut the cord? If all is well with mama and baby, can we wait until the cord stops pulsating? Can my husband cut, if he wishes?
How much time do you allow for the delivery of the placenta?
Are you okay with the placenta being delivered underwater?
What is typically done with the placenta afterwards? Are there any legal restrictions on disposal? Can I have it encapsulated? Do you or someone you can recommend provide this service?
How do you detect partially retained placenta? How do you treat this?
How often do hemorrhages occur?
How would you handle a hemorrhage? Do you carry pit, placenta smoothie or herbs for this? At what point would you recommend transfer for medical management of hemorrhage?

What would you do for a floppy baby? How often do you see this? Do you carry infant resuscitation equipment? Are you certified in infant resuscitation?
What are the most common minor complications you see, and how do you typically treat them?
What happens if my perineum needs stitching/suturing? Can you do that? Are you comfortable with repairing 2nd/3rd/4thdegree tears?  How bad does a tear have to be before you use stitches?
Do you help with cleanup (laundry, etc.)? What do you typically do?
How long do you typically stay after the birth?
Complications
Do you have a working relationship with one or more particular OBs to whom I would be referred in the event of a complication? What hospital would you prefer I transfer to?
What situations do you consult an obstetrician for? How commonly do these occur?
What problems or complications in pregnancy would mean that a obstetrician would become my primary maternity caregiver?
Under what circumstances do you transfer to hospital?
What hospital would I be transferred to?
What would be the plan of action if a transfer to hospital were necessary during labor?
Would you stay with me in the hospital? In the operating room? For how long after the birth?

Post-partum
Do you examine the baby after birth? What do you look for? What tests do you perform? Do you recommend eye ointment and/or Vitamin K? Oral or shot? Why or why not?
Do you have any special things you do for the mom after a birth such as an herbal bath?
How do I obtain the baby’s birth certificate/SSN?
How many postpartum visits will there be? Where will these take place? What do they include?
Do you examine the baby at any or all of your visits, and if so, what does the examination include?
When do you recommend that we take the baby to his/her pediatrician for the first time, and why? (Assuming normal delivery and healthy baby.)

Financial
Will you try to bill my insurance company? How?
How much is the fee for birth alone, vs. prenatal care plus birth? If I need extra prenatal visits or labs, how much are these?
What is included in the fees? What will I need to provide? (Birth kit, lab fees, etc.)

Depending on how you feel, do you want to know her stance on circumcision or vaccines? Breastfeeding and/or support? Will she support you continuing to breastfeed a child through pregnancy? How many children she has and how she birthed them? What she recommends for nutrition (how much protein, etc.)? What other certifications does she possess?