The short answer: Ask about her training and experience, who comes to the birth with her, what she brings, and her plan if you ever need a hospital. Then ask the questions that are really about you: how she'll prepare you, how your partner fits in, and what it all costs. And notice how you feel while you talk. That feeling counts too.
By Sybille Mom of two · first birth in a hospital, second at home · Education only, not medical advice
In my first pregnancy, I hardly asked anything. Fear guided my whole pregnancy, so I did what was recommended to me and kept my questions to myself. I didn't even know I could ask.
By my second pregnancy, I'd learned to ask. Big questions, small questions, and one I'd never have dared to say out loud before: what does labor actually feel like when I'm not numb? Every answer made me feel a little calmer.
So here's the list I wish I'd had the first time. You don't need to ask every question. Pick the ones that make your heart beat a little faster, and bring them to a free consultation. Many midwives offer one.
First, a tiny bit of homework
In the US you'll mostly meet two kinds of home birth midwives: CNMs (certified nurse-midwives, licensed in every state) and CPMs (certified professional midwives, who specialize in birth outside the hospital; licensing varies by state). The ACNM's comparison of midwife credentials explains the difference simply. To find midwives near you, try the ACNM, NARM and the American Association of Birth Centers.
Her training and experience
- What's your training, and which credential do you hold?
- Are you licensed to attend births in our state?
- How many births have you attended as the lead midwife?
- Are you trained in newborn resuscitation, and how do you keep your skills fresh?
- Could I talk to a couple of families you've cared for?
Who comes with her
- Who else comes to the birth: a second midwife, an assistant?
- Who's your backup if you're sick, or at another birth that night?
- Can I meet everyone before labor? (New faces are fine, just maybe not in the middle of a contraction.)
When I asked my midwives whether I needed a doula, they smiled and said, "We are your doula." Ask yours, and listen to how she answers.
Your pregnancy care
- How often will we meet, where, and for how long?
- Who orders my lab work and ultrasounds?
- How do you prepare women for birth? Are there classes you recommend?
- How can I reach you between visits, and how quickly do you usually reply?
Labor and birth
- When do you come to me once labor starts?
- How do you listen to my baby and check on me during labor?
- Can I eat, drink, move and use a birth pool? (I had a steak dinner, and about five minutes later it was go time. Zero regrets. 🥩)
- What comfort tools do you use?
- How will my partner be part of it, and older children if I'd like them there?
What she brings
- What equipment and medicines do you bring to a home birth?
A typical kit includes a handheld device to listen to your baby's heartbeat, a blood pressure cuff, oxygen, equipment to help a baby breathe if needed and medicine to help with bleeding. What's included depends on her training and your state's rules, so it's a great thing to ask about.
If plans change
- Which hospital would we go to, and how long does it take to get there?
- What would make you recommend seeing a doctor during pregnancy, or going to the hospital in labor?
- Do you come with me if we transfer, and do you send my notes ahead?
- How often do the first-time moms you care for end up transferring, and why?
That last one can feel awkward to ask. Ask anyway. There's no "right" number. What you're listening for is how calmly and clearly she explains it.
After the birth
- How many postpartum visits do you make, and where?
- What newborn checks and screenings do you offer?
- Who helps with breastfeeding?
- Who do I call at 2 a.m. in the first week? (There will be a 2 a.m. call.)
The money questions
- What's your total fee, and what's included?
- What's not included? Lab work, ultrasounds, a birth pool, hospital or ambulance costs if we transfer?
- Do you bill insurance or give me what I need to ask for reimbursement? Can I use my HSA or FSA?
- Do you offer payment plans?
Every practice packages things differently. For example, one midwife's practice lists hospital, lab and ambulance charges as not included in its package, so it really pays to ask.
The question no list can answer
After the call, sit quietly for a minute and notice how you feel. Calm? Heard? A little bit loved? My midwives felt like superheroes to me. They paid attention to everything, and often understood what I needed before I said a word. As my midwife always said, pregnant women need to feel loved. If your gut says yes, that matters.
And one last question for her: Do I have to decide right now? A good midwife will smile and give you time.
Whatever you choose, talk it through with an experienced midwife and your care provider. They know you and your pregnancy, and they're the right people to help you decide.
Questions moms ask
How many midwives should I interview?
One or two is plenty for most women. Many midwives offer a free consultation, so you can compare how each one answers your questions and how you feel with her.
When should I start looking for a home birth midwife?
Many women start looking early in pregnancy, but it's rarely too late to ask. Some practices welcome women who switch later in pregnancy, so just call and ask what's possible.
What's the difference between a CNM and a CPM?
A CNM (certified nurse-midwife) is a nurse with graduate midwifery training and can be licensed in every state. A CPM (certified professional midwife) specializes in birth outside the hospital, and licensing depends on your state. Ask any midwife which credential she holds and what her license allows where you live.
Is it rude to ask a midwife how often her clients transfer?
Not at all. It's one of the kindest questions you can ask, for both of you. A good midwife expects it and will tell you how often her clients transfer, the usual reasons, and how she handles it.
What if I don't like the answers?
Then you've learned something important, and that's a good thing. Keep looking until you find someone who makes you feel calm, heard and cared for.
