Too often, when the discussion of a homebirth complication comes up, the ineptness of the midwife’s actions comes into play. How would a potential client know if her chosen midwife is up-to-date and practiced with her skills? I’m going to propose something completely unique to anything I’ve ever heard before, an addition to the interview process that might actually have a hand in 1) helping women choose the most competent midwife 2) help midwives practice their skills until they are body memories and can be done in their sleep… or during an acute emergency.
Ask to attend a skills training session with the midwives so you can see who is the most adept handling the fake emergencies. You don’t need to know how she is supposed to handle a shoulder dystocia or a surprise breech because they will be discussing that in the session. You’ll get an idea of who the “leaders” are as far as teaching the skills (usually the midwife with the most experience in that skill) and who has the least knowledge about a certain skill. I believe just asking to attend this type of session would give you an enormous amount of information about the level of transparency and disclosure the midwives in your area offer. If you’re refused entry, that speaks volumes. If you’re permitted in, that also speaks volumes.
Skills that should be observed:
- Starting an IV
- Neonatal resuscitation
- Adult CPR
- Shoulder Dystocia resolution
- Surprise Breech
- Surprise Twins
- Cord Prolapse
- Postpartum Hemorrhage
- Calling 911
It's unlikely you'll be seeing all those in one session, but that a group of midwives even putting on a public session says great things about their willingness to display their knowledge and skill.
I do agree midwives deserve to have a safe space in which to learn and grow their skills, but if holding a public skills session forces the wary midwives to practice their heads off for the event, everyone wins… especially the mom and baby.
I look forward to feedback from moms about how this request works in your community.