How to find and hire a private midwife

The process of hiring a private midwife can be dauting.  

While you likely have family and friends who can share personal insights, experiences and recommendations for private obstetricians, it is quite unlikely that you know someone who has used a private midwife in your area.  

This is because despite compelling evidence that midwifery-led continuity of care improve outcomes for both mother and baby (https://www.cochrane.org/CD004667/PREG_midwife-led-continuity-models-care-compared-other-models-care-women-during-pregnancy-birth-and-early) currently only 8% of women in Australia have access to this kind of care.   

Due to the small number of privately practicing midwives in Australia many women will not have access to a private midwife who services their area, let alone multiple.  

If you are lucky enough to have options, this article will help outline three easy steps you can take to help find the right private midwife for you.  

Step 1: Find a private midwife that services your area  

If you are at the very beginning of your journey, consider starting by joining some local homebirth and natural childbirth groups on Facebook. If you are in Australia I have found “Homebirth Group Australia” on Facebook to be a particularly helpful starting point.  

Here you can post your location and the type of midwife you are seeking and you will find many women (as well as midwives themselves) who are happy to share their recommendations for midwives in your area. This can also be a great opportunity to hear from other women about their personal experiences with these midwives.  

Step 2:  Interviewing potential midwives 

Once you have narrowed down your options, most private midwives will offer a no cost, no obligation chat (either by the phone or ideally in person), which allows you to ascertain whether you are a good match for each other.  

While the goal of this “appointment” is to just get a general feel for each other, coming prepared with a list of questions can help you to understand how your midwife operates and her general philosophy surrounding birth.  

Step 3: Come prepared with a list of questions for potential private midwives 

The decision to hire a private midwife comes with a significant financial investment. Asking appropriate questions is part of your due diligence as a client to ensure this investment is well placed and that you are setting yourself up for a positive experience. So don’t hold back. This is your opportunity to ask your questions, calm any fears you or your partner may hold and to set in place a really great foundation for a positive pregnancy, birth and postpartum experience.  

To help you to out we have included below 27 possible questions to ask a private midwife during this chat. Print them out. Highlight the ones that feel relevant to you. Add any other questions you feel are necessary and take a notebook along with you.  

Logistical:  

1: How many women do you care for per month?  

2: Have you ever had two mothers in labour at once? How did/ would you manage this scenario?  

3: Are you planning to have any scheduled time off that may impact on my antenatal, birth or postnatal care?  

4: Who is your secondary midwife?  

5: When will I meet your second midwife and what role will she play in my care/ birth?  

6: If you are sick or unavailable at the time of my birth how is this managed?  

7: How much do your services cost? Do you offer payment plans? When will you require final payment by?  What is included in the costs for your care? (example birth pool hire).  

8: Do you have admitting rights to any local hospitals; why/ why not? (If your midwife does not have admitting rights in a hospital, this is not necessarily a red flag. There are many valid reasons –why they may not. However if this is important to you, it is best to know up front).  

9: If I need to go to the hospital at any point during my pregnancy, birth or postpartum period, what role will you play in my care?  

10: How many women have you supported in home birth?  

11: Are you a registered midwife? (Midwife is a protected title in Australia so only registered midwives should be operating under this title)  

12: Do you offer any antenatal birth education?  

 
Philosophical:  

13: What would you say a “standard” birth looks like under your care?  

14: What role would you play in my birth?  

15:: When do you “normally” perform vaginal examinations and when would you strongly advise one? Are you comfortable supporting a woman who declines all vaginal examinations?  

16: How do you feel about antenatal testing (could include GBS swabbing, gestational diabetes screening, ultrasounds etc.)  

17: Are you comfortable supporting women who refuse any or all of these tests?  

18: Are you comfortable supporting women who are; high risk, planning a VBAC, high BMI, having a breech baby (any other variation of normal that feels relevant to you)      

19: How do you feel about; vaginal examinations, cord clamping, physiological third stage etc.  

20: Have you ever terminated care with a client? What were the circumstances surrounding this?  

Safety:  

21: What emergency equipment do you carry? How does this differ to what is available in hospital?  

22: How do you manage a postpartum hemorrhage? How does this compare to how it is managed in hospitals?  

23: How do you manage shoulder dystocia? How does this compare to how it is managed in hospitals?  

24: How do you manage infant resuscitation? How does this compare to how it is managed in hospitals?  

25: How do you manage tearing? Are you comfortable and experienced repairing tears at home or would this require a hospital transfer?  

26: What is the most common reason your clients transfer to hospital? 

27: Is homebirth as safe as hospital birth? 

By asking these questions, the hope is that you will emerge from this meeting feeling more knowledgeable, empowered and with a greater sense of whether this midwife will be a good match for you.  

Once you have determined who will be the right midwife to guide you through this journey, they should advise you of the next steps.  

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