questions I asked my doctor and how I ended up with a midwife

Disclaimer: I'm not a health care provider. If you're expecting please seek out the wisdom of your care provider. These are my experiences and opinions. 

Before I changed my care from a traditional OBGYN to a Midwife I came prepared to ask questions. I love my OBGYN, and I prefer using that model of medicine for well women checks, but I knew my philosophy for birth might pair best with a midwife. I was also able to choose care through a midwife, because, as of now I've been categorized as "low risk." 

In Minnesota we have a somewhat friendly position towards midwifes. There are several practices within our bigger health systems that include midwives who deliver in the hospital. Those midwifes are called CNMs, certified nurse midwives. CNMs have the greatest freedom in where they can provide care: hospital/health systems, birth centers, and home births. CNMs can provide well women care, write prescriptions, and deliver babes {vaginally}. Then there are CPMs, certified professional midwives. CPMs have attended midwifery school and provide care at birth centers and home births. CLMs, certified lay midwives, are able to practice at home births and sometimes birth centers {I believe, depending on the state}. 

Presently, I am being seen by a Health Partners CNM, until we've made our final decision on where to birth. I plan on working with a midwife during this entire pregnancy. 

To me, education is key. I don't want to enter into an experience like birth {something I've never gone through} without having as much information as I can. I have strong opinions about many things 😉 I believe in advocating for myself and doing my own research. 

Here are the questions I asked my doctor before I switched to a midwife. She was wonderful, answered them, and then actually recommended that I continue my care with a midwife. 

Below each question I will explain why I asked what I did. Also, I found this list and edited the questions to fit my needs on one of my favorite birth blogs BabyLove, which sadly closed :(. 

Will you be the one to deliver our baby?

Most doctors and midwife practices have multiple care providers. This means depending on the size of their practice that you may not meet the person who is delivering your baby until you are delivering– or sometimes there's an on call doctor at the hospital. To me, I wanted to at the very least meet all the people who might be actually attending my birth. Birth centers have much smaller practices, and with home births you can end up seeing the same midwife across your entire care.  

What are the hospitals that you/your group deliver at?

Well. Here's where I get opinionated. There are hospitals in our metro I would not be comfortable birthing at due to cesarean stats {not taking into account if they're a hospital that takes on lots of high risk mamas– like HCMC, which is actually the only hospital I am considering presently, more on that later} and the experiences of other women around me. I care much less about how pretty the L&D area is and what birth are actually like there. 

What is the cesarean rate for your group?

It's important to look at both the group rate AND the location rate. They may be different. If you're a woman of color like I am you need to add 5% on to every cesarean stat. We're much more likely to be forced into c-sections than our white peers. 

When was the last time you did an episiotomy?

These are becoming much less common, but again, I felt it important to ask. 

Would I be able to have a water birth?

Sadly, lots of hospitals advertise water births, but sometimes women arrive hoping to have a water birth and find out that certification isn't up to date or that water births are only offered for those who see a CNM versus an OBGYN. Again, ask. I don't know if I want to have a water birth or not, but I'd at least like the option of one. 

Can I do skin to skin right away?

The benefits of immediate skin to skin are huge. Most hospitals at least in MN provide this for healthy moms and babes, but again– ask. 

How quickly after birth do you clamp the cord?

This is imperative if you're thinking of doing delayed cord clamping, or at least want the option. 

If we’d like to hold off on baby having a bath, is that okay?

Some babes are born with a milky-cheesy coating called vernix. There are benefits to leaving the vernix on babe and rubbing it into their skin. Babes really don't need a bath immediately and while many are catching on to this, it's still standard procedure in the hospital to give babe a bath. That being said: my ob shared that one of the reasons a bath is done is that the nurse can do a quick head to toe check, but again it's possible to do a check without a bath. 

Do you allow doulas and birth photographers?

How sad to show up with your team and be told "no." I haven't heard of this happening, but again, ask. 

Will I be able to eat during labor?

I have no idea how I will feel during labor. However, I do know what it's like to do a really hard CrossFit workout without having eaten properly beforehand. I at least want the freedom to eat and drink. 

May I labor in the clothing of my choice?

Again, maybe people care about this or not, but I don't want to be forced into clothing I don't want to wear, though a gown seems totally fine honestly. 

Are you okay with me using an upright pushing position?

Lots of mamas like to squat or NOT be on their back during the pushing phase, which is actually not ergonomically correct. At least I want the freedom, as I know lots of women who prefer birthing on theirs backs. 

Will I be required to lay down for the actual birth?

See above :) 

Do you do a lot of VBACs?

In the event of a cesarean I'd want to know if a VBAC would be possible for me second time around. This is another important question to ask as having multiple cesareans can limit the number of children you have, which I find honestly, oppressive.