Over and over, we hear for potential homebirth clients to not only interview the midwife (which I’ve discussed at length here, here, here, here, here and here), but to also ask the midwife for references. But what do you do with those references? And since they’re coming from your midwife, how to you find dissenting opinions or learn about her less glorious beliefs and actions?
The first is to check with The Birth Survey (TBS). The Birth Survey, while not terribly comprehensive, can be a good springboard. (Note: I cannot get the thing to work for me for anything. It says I need a new “key,” but doesn’t lead me to it and when I copied the url it says to go to, it’s a giant technogeek site I can’t figure out. Does anyone have any ideas so we can access the site? Are others having the same problem? TBS people need to fix this glitch!) It’s important to know TBS has its limitations, too. For example, my own section includes negative reviews along with awesome ones. Who’s right? Obviously, it’s an individual decision based on what a woman wanted, expected and received.
When you get the names of past clients from the midwife, you’re surely going to get the women who gave those rave reviews. So, how do you filter their enthusiasm to learn the information you’re needing before making the final decision about who you hire to attend you at your homebirth?
I highly encourage you to consider visiting the referrals in person. While the same information can be imparted over the phone, actually seeing the person’s face can tell you more. Plus, if she has birth photos or a video she’s willing to share, that can give you information, too.
Was the birth straightforward? Did anything unusual happen the mom can tell you about? Did she have an extra long labor? GBS that was treated with Hibiclens? A breech baby at one point the midwife said she didn’t have a problem delivering at home? These give you information that the she tends to operate out of the low-risk standard of care and/or is inclined to use “alternative” methods for medical issues; definitely not evidence-based.
Did she talk to the mom about possibly risking out at any point? Was she post-dates? Did she have a persistent urinary tract infection? Did her water break before contractions began? If the midwife even brought up the topic of transferring care, kudos to her. Too many midwives ignore the issue and when it’s brought up, will merely say, “Don’t worry about it. That’s not going to happen.” Sadly, if/when it does, the mom isn’t at all prepared for it. A midwife who discusses transferring long before the possibility is offering kindness and respect for the woman’s intelligence and sensitivity.
Speaking of transfers, when asking the midwife for referrals, be sure to ask for at least two transports… preferably one transfer (non-emergent) and one transport (emergency). How a midwife performs her duties during times of stress can give you a lot of information. Ask the previous client how the midwife handled the complication, about her demeanor during the emergency. Did she know her stuff? Also, how did the midwife act with the transport team? Was she cocky? Or was she respectful. When in the hospital, how were the interactions between the midwife and the nurses and doctors? Did the midwife ask you to lie about any aspect of your labor or birth? Did she lie about anything? Was she forthcoming with sharing your records with the staff?
The answers you’re looking for, in my opinion, should focus on the health and safety of you and your baby. It’s easy enough to get a hands-off midwife; it doesn’t take added skill to do this. But, it does take extra skill to know how to do neonatal resuscitation and manage a hemorrhage. Did your potential midwife have to attend to any variation from the norm? Ask her for references that include these types of births.
I do know it’s hard to know what to ask when you’re a novice yourself, but the above questions can give you an idea about the midwife whose actions you’re exploring. I encourage you not to just accept referrals that chirp happily about the midwife. While she shouldn’t have been a part of a debacle, having her being human says a lot. Has she said, “I’m sorry” to the client? (Perhaps she had to change course mid-stream.) Does she exhibit humility or arrogance? Do women speak about her like she’s a goddess or a woman who works hard for women and their babies? Be careful of the “heroes” among us; they rarely hold up under scrutiny.
I’d love to hear from others about what they’ve asked referrals or what they wish those looking for a midwife would ask them. I want to add to these questions… feel free to let me know your thoughts.