When you’re pregnant, the planning can be super fun. Daydreaming about tiny baby socks and who to invite to your baby shower. Using Pinterest to create a board full of baby everything. But when it comes to the medical part – the birth part – most people really dread this planning. They don’t know what questions to ask or what to do with the answers.
Here is your complete guide to interviewing and hiring your birth team. Compiling over 30 resources and including my own personal experience as a certified birth doula and mom of two, I’ve put a lot of time into creating this guide for you.
I’ve chosen to weed out questions that provide information most people don’t know what to do with – like what type of training someone has had and with what organizations. This is great info but only if it means something to you… and most people don’t know the differences.
So here it is. Your complete and truly helpful guide. Grab a snack, a big glass of water, and get comfortable because you’re about to learn:
- Why you even need to be asking questions
- What types of questions will provide you with the most helpful information
- The differences between options of people for your birth team
- A complete list of questions for doulas, obstetricians, midwives, and yourself – plus what types of answers you might be looking for
- What to do if you want to change your team members after you’ve hired them
WHY ASK QUESTIONS
Our transition into motherhood and parenthood is impacted greatly by our birthing experience and rite of passage into this crazy new era of our life.
When we feel supported and empowered in our birth experience, we flow more easily into motherhood with more trust in ourselves, our body, our baby, and our connection with our partner.
If we have a challenging birth experience where we feel unsupported, lonely, or out-of-control, our transition into motherhood often carries sadness, defeat, distrust, and disappointment. These emotions make it much harder for us to bond with our baby and our partner in those fuzzy early postpartum days and weeks.
In other words, research is telling us that positive perceptions of birth experience lead to improved quality of life including mental health, physical health, parent-infant attachment, and relationship satisfaction.
On the other hand, women who subjectively report their experiences as negative are at an increased risk for postpartum depression, anxiety, or PTSD, and often have difficulty bonding with their babies and partners in the early postpartum period, including challenges with breastfeeding.
It is a privilege to be asked to attend our birth. Our partner and loved one is asked to support us and advocate for us because we trust them. Perhaps we invite more family or friends to attend our birth, as well, but only if we know they will be calming to us and help us feel more supported and at ease.
Our professional birth team should also feel privileged to attend our birth. We are choosing to trust them, confide in them, and rely on them. We expect that they will keep our best interests at heart and stand up for us in the toughest of times.
If so much of our well-being as a mother and partner in the coming months and years depends on our experience during childbirth, we need to make sure we are creating the strongest, most trusted team we can.
We need a birth team that makes us feel comfortable, at ease, safe, and supported.
We need one that listens to us, respects us, and helps us feel empowered – even when birth is out of our control.
This is a tall order for our team members so we need to ask lots of questions and make sure we are picking team members who are up for the challenge and who can want what we want.
HOW TO ASK QUESTIONS
It’s hard to know what questions to ask and believe me, I know how overwhelming it can be to look through all the various lists and try to figure out which questions to use.
So I’ve helped you out and compiled questions from over 30 different resources. Below you’ll find these lists but don’t be fooled – they could never be a fully complete list without some personalization.
Read them through and then add a couple of your own questions to them. Get more specific about your own personal birth preferences.
As you’re making your own questions, avoid questions with yes or no answers. Ask open-ended questions that will provide you not only more information, but also give you a better feel for how this person communicates and interacts with you.
How they answer the questions is just as important as what they answer.
Also, these lists are pretty in-depth. There are 25 questions to ask when you’re interviewing birth doulas and then 40 questions to ask when you’re interviewing an obstetrician or midwife.
That’s a lot of questions.
If you allowed even just three minutes to discuss each question, you’re looking at just over an hour with your doula (which is probably feasible) and two hours with your obstetrician or midwife.
You definitely won’t get two hours.
You’ll have to pick and choose your favorites.
After your interview, you’ll find 15 more questions (below) to ask yourself so you can reflect on your experience.
You should take two hours for this.
It doesn’t have to be two hours all at once but put some real thought into it. This is important. If you can, chat about these reflection questions with other members of your birth team – or close friends and family.
Even with all of that, here’s something to keep in mind:
You likely won’t get two hours to interview your medical provider (your best chance of this would be if you decide to go with a midwife for a home birth or birth at a birth center), but be aware of how much time they are giving you for you to ask your questions.
You’ll see more on this in your reflection questions later but here’s the key point:
If you aren’t given enough time to ask the questions you want to ask, you probably won’t feel comfortable with your provider.
CHOOSING YOUR BIRTH TEAM
You’re almost ready to ask questions but maybe you aren’t sure who you should be asking. Below I’ve outlined and defined the role of a doula as well as the differences between a midwife and obstetrician so you can choose the care provider who will be best for you.
Certified Birth Doula
Certified birth doulas are professionally trained, non-medical, labor support partners.
If you’re looking for a doula, you want to specifically find one who is certified or perhaps professionally trained but still “training” – meaning she hasn’t yet completed the number of births to be certified. Doulas in training are a little less expensive – although truly even the full priced doula fees are more than worth it.
Research tells us that having a doula present for your labor leads to statistically shorter labors, less of a likelihood to need pain medication, less use of vacuum or forceps (“assisted delivery”), significantly lower cesarean rates, higher APGAR scores (your baby’s responsiveness immediately after birth), and overall higher birth satisfaction. [source]
If you aren’t sure how to know if a doula is certified, ask! And don’t bother interviewing any who don’t have professional training.
Certified birth doulas aren’t just well-read on positions and soft with their words – they are specifically trained to be able to support the health of both mother, baby, and partner while working in collaboration with medical providers (always with respect) and adjusting to any birth environment.
Doulas who are not certified or professionally trained may have inaccurate or out-of-date information, overstep their roles alongside the medical providers, and could actually inadvertently harm you or your baby.
DONA International is currently leading the evidence-based doula world, including training, certification, and continuing education. If you’re looking for a doula, I would suggest starting with browsing DONA’s list of certified doulas here. All of these doulas are certified through DONA and are keeping up with ongoing continued education to stay informed on the latest and greatest in the birth support world.
A certified doula will…
- Assist you physically throughout your birth to make it as comfortable as possible. This may include using massage, hot/cold compresses, water (bath or shower), or other tricky doula techniques for comfort and pain management. One of my favorites was to give mamas a short barbers comb to squeeze in one palm – the sensation of squeezing the comb would distract during contractions
- Suggest ideas for position changes. It’s important to keep moving during labor so you can help your baby move down and out. Some positions help more than others and a doula can suggest different positions that will still be effective even if you’re exhausted and find some angles unbearable.
- Provide emotional support and encouragement. Doulas seem to know just the right words to help women manage through the toughest moments of labor. They are nurturing, encouraging, and gentle. They also are the only person on your birth team who is solely focused on you and your emotional well-being.
- Help you feel as informed and empowered as possible. Certified doulas are wonderful advocates to support you during your birth. They can answer questions for you and direct you to resources while you get to know each other during the prenatal visits so you feel prepared and educated. They can also help you find space to consider all of your options during the delivery itself. A doula will never speak for you to medical providers but they can help remind you (or your partner) that you can ask questions and challenge decisions sometimes. You’ll especially want to make sure you have a certified birth doula because they are trained to know how to work respectfully alongside obstetricians and midwives and never pretend to be the medical expert on childbirth.
- Support your partner during your birth. While you of course need the most support, a doula will also help support your partner if you have one present. Oftentimes in my own role as a doula, I felt that the hardest part of my work was supporting the partners – helping to make sure they have eaten and slept, encouraging them to go for a walk and take a few breaths in the fresh air, or letting their hands and arms take a rest from intense massage. Sometimes anxiety from partners about their loved one in pain can actually make things worse so a doula will be able to redirect that anxiety, provide positive words of encouragement, and model how to be supportive. Partners usually want to be more hands on but just don’t know how. A doula can help show them.
A certified doula will not…
- Provide any medical advice. If this is your first baby, you’ll have probably 10-50 new questions every day during your pregnancy. A doula is a wonderful way to ask a professional “is this normal?!” without having to wait for your next prenatal appointment with your midwife or obstetrician. If your doula doesn’t know or if there is any chance at all that this might be a medical concern for you or baby, she will suggest you contact your medical provider. She will never answer medical questions but she can probably let you know that yes, it’s normal for a weird dark vertical line to appear on your belly as it grows enormously big.
- Complete any medical tasks. If you need any sort of medical anything at all, you will go to your medical provider. Your doula will not ever check your blood pressure, do a vaginal exam, or assume any other medical responsibilities.
Doulas are not usually covered by insurance but typically won’t cost more than $1,200 – which is an incredible deal if you add up all of the hours of support they provide on top of being on call for you.
Obstetrician (OB-GYN)
An obstetrician is a medical doctor who is professionally trained and licensed to provide medical and surgical care to women during pregnancy and childbirth.
Obstetricians tend to intervene more in birth because they can and they were trained to. Their professional training is focused on managing high-risk pregnancies and performing surgical interventions when necessary.
They will likely be in and out during your labor to check-in but will not be very available for emotional or physical support.
Due to their medical and surgical training and approach, obstetricians work only in hospital settings and their care will be covered under your insurance.
Midwife (CNM)
A certified midwife is a nurse who is professionally trained and licensed to provide obstetric and newborn care.
“Midwives are the experts in normal pregnancies,” said M. Christina Johnson, CNM, Director of Professional Practice and Health Policy at the American College of Nurse-Midwives in Maryland.
The field of midwifery is known to be “low tech, high touch.” They can use technology (like fetal monitors) and can prescribe medications but they tend to rely heavily on clinical experience. They will likely be in and out during your labor to check-in but will sometimes sit down and chat with you or offer emotional or physical support during your labor.
Most midwives practice within a hospital setting but many also practice outside of hospitals at birth centers or assisting in home births. Their care will be covered under your insurance if they are working in a hospital.
If you’re planning a home or birth center delivery, you’ll likely be paying out of pocket – although the cost is usually only around $3,500 (about the same as your hospital birth deductible).
Obstetrician vs. Midwife
Still not sure which one to go for? Here’s the bottom line:
Obstetricians are trained to perform pregnancy-related surgery and attend to high-risk pregnancies as well as more complicated births, such as twins or breech.
Midwives are trained for childbirth. While they have some training and awareness of more complicated births, high-risk pregnancies still tend to be migrated over to obstetricians within hospital settings. This is likely due to not only the type of training that obstetricians receive versus midwives, but additionally to the higher likelihood of needing surgical interventions in high-risk pregnancies.
And again, obstetricians are specifically trained to be surgeons.
So if your pregnancy is low-risk, you are going to be better suited with a midwife who is trained for the broad range of normal childbirth and whose approach will likely be more comforting, flexible, and at ease.
If your pregnancy is low-risk, you would likely not want an obstetrician because you don’t want your “normal” pregnancy to be approached from a more surgical theoretical stance.
While obstetricians can deliver low-risk, vaginal births, this is not the focus of their training.
If your pregnancy is high-risk for surgical intervention, you are likely going to feel more comfortable with an obstetrician who has more training in the abnormalities of birth.
If your pregnancy is high-risk, you would likely not want a midwife because you want someone specifically trained in surgical interventions and “abnormal” birthing scenarios. While midwives can deliver for high-risk pregnancies, this is not the focus of their training.
Essentially, pick the provider who has the training that best fits your situation.
25 BEST INTERVIEW QUESTIONS WHEN HIRING A DOULA
- What are your fees and what is included if I hire you? How many visits do you do while I’m pregnant and after the baby is here?
- What topics do you cover during your prenatal visits? Will you come to my house for those visits?
- How long will you stay with me after I give birth?
- What happens in your postpartum visits? How long after having the baby can I reach out to you with questions?
- What do you think is the most helpful type of support for women while they are in labor? What do you typically do when supporting your clients in labor and birth?
- How would you describe labor and delivery?
- What things do your clients usually want the most support with during the birth itself?
- What is your relationship like with husbands or boyfriends? Can you tell me some stories of what their role looks like with you at the birth?
- What is your relationship like with the midwife or doctor during a birth? What happens if you disagree with something they suggest?
- What is the newest thing you’ve learned about being a doula?
- What is your opinion of natural birth, pain management, and cesareans?
- How do you support clients during cesarean births?
- How many clients do you take on each month? Do you have any other clients with due dates near mine?
- When will you be on call for me? What happens if my baby comes before you are on call?
- Are there any dates that you won’t be available?
- What happens if you miss my phone call when I go into labor?
- Do you have a time limit for long births? If not, what do you do to make sure you’re able to support us the whole time?
- Do you have a back-up doula? If so, I would like to meet her.
- Have you attended births at my birth location? And if so, what has been your experience there?
- What do you love about being a doula? – passion
- What areas of support do you feel really comfortable with? What are you really good at?
- What areas of your work do you feel you are still working to improve?
- What is your approach if your client is being stubborn during labor and isn’t trying new positions that will help her?
- What happens if you see my birth going in a direction I don’t want it to go and you feel like you’ve done everything you can to help me?
- Tell me about your favorite birth you’ve attended. What was the hardest birth you have been to?
40 BEST INTERVIEW QUESTIONS WHEN HIRING A MEDICAL PROVIDER
- What topics do you cover during your prenatal visits? What type of education do you provide?
- How long are these prenatal appointments?
- Will I meet with you for each prenatal visit and delivery of my baby?
- If this is a group practice, what happens if there is a provider I’m not comfortable with?
- What happens if you have two clients in labor at the same time?
- What do I do if I have questions between appointments?
- What do you expect regarding self-care during pregnancy?
- What is your role during the labor and delivery?
- What choices do I have in the decision making process during my delivery?
- I recognize that birth is unpredictable. As of right now, do you foresee any problems with my birth plan?
- What do you think is the most helpful type of support for women while they are in labor? What do you typically do when supporting your clients in labor and birth?
- What are your thoughts on birth doulas? Are they allowed to continue to support me in the event of a cesarean birth?
- How would you describe labor and delivery?
- How often will you be with me during labor?
- What is your opinion of natural birth, pain management, and cesareans?
- What do you consider a high-risk pregnancy?
- What happens if I reach 42 weeks and am still pregnant?
- Under what scenarios would you recommend induction? What is your personal induction rate?
- Under what scenarios would you recommend an epidural? What is your personal epidural rate?
- What is your personal cesarean rate?
- What is your success rate with VBACs (vaginal birth after cesarean)?
- What is the most common reason you find a cesarean rate to be necessary?
- What are your views on premature rupture of membranes (PROM)?
- What do you do if my water breaks but I have no signs of infection?
- How do you handle a “stalled labor”? What do you consider a stalled labor?
- How will you monitor the baby? How often?
- Do you have a time limit for long births? What happens if I approach the limit?
- What is the most common birth position for you? What other positions have your clients chosen?
- What techniques do you encourage during pushing?
- What are your views on episiotomy versus tearing?
- What types of births do you not feel comfortable delivering? – breech, twins
- What prenatal tests do you require and/or recommend? Are there any exceptions to these?
- What procedures do you perform on the baby? Are there any exceptions to these?
- How long do you wait to clamp the cord if I request delayed cord clamping?
- What usually happens with the baby immediately after I’ve given birth vaginally? What about a cesarean birth? – skin-to-skin
- What does your support look like after I’ve had the baby? What happens if I need to process what happened with you?
- What hospital policies do you agree with?
- What hospital policies do you disagree with?
- Tell me about your favorite birth you’ve attended. What was the hardest birth you have been to?
- What is the one thing you wish women knew about childbirth?
15 QUESTIONS TO ASK YOURSELF AFTER INTERVIEWING YOUR TEAM
- Did I feel heard, listened to, and respected?
- Did I feel comfortable with them? Were they easy to talk to?
- Did they seem compassionate and personal?
- Did they ask me any questions? Did they seem interested in me and what I want for my birth?
- Did they smile?
- Did they communicate well and seem knowledgeable?
- Did their views on pregnancy, childbirth, and medical care align with my own beliefs?
- Did I feel rushed?
- Was it easy to make an appointment with them?
- Did my partner feel comfortable with them?
- Did I feel judged?
- Did they seem like a good fit?
- Am I looking forward to having them there for me when I need them?
- Did they seem enthusiastically supportive – or did I get the feeling they would just “be willing to try that”?
- If it is a group practice and I may not meet with this individual each time or have them there for the delivery, how will I feel about that?
HOW TO INTERVIEW MY BIRTH TEAM?
Did you know you can interview more than one provider? You can meet with one midwife and three obstetricians? Or two of each?
No matter how many you meet with and how nerdy it sounds, take notes during the appointment. It can be really hard to remember all the details later.
Depending on the practice guidelines, they might try to bill your insurance for your first prenatal appointment – which means you can only have one first appointment before your insurance company will start wondering what’s happening. But a lot of times you can call and specifically schedule an interview that won’t be billed through insurance.
Many hospitals with group practices also hold meet-and-greet events for you to come meet a panel of midwives and ask questions to the full group. These are less formal, they usually offer some sort of education, and they typically answer questions in a panel format where more than one provider may speak to a specific question.
Oftentimes, there is a tour of the labor and delivery floor right before or after the panel. Our bodies and minds want to feel safe during labor and it’s helpful if when we leave the comfort of our home, we have a familiar space to be heading towards.
And really, you’re interviewing the location of your birth just like you’re interviewing your care providers.
I haven’t yet heard of this meet-and-greet practice with obstetricians but I’m hoping it is catching on.
For home or birth center births, you have more flexibility in interviewing. Oftentimes an initial consult is encouraged. These meetings tend to be more laid back even than the group panel format. With my own midwife, we sat on couches with real pillows and drank tea. Talk about comfortable.
WHAT IF I WANT TO CHANGE MEDICAL PROVIDERS?
Most people think that once you choose a midwife or obstetrician (or even birth setting in general), you have to stay there. They assume they have made a commitment and aren’t really allowed to change their mind.
Here’s the real truth:
You can change your mind at any point in your pregnancy.
You could have had all of your prenatal visits with one hospital or obstetrician and then at the last minute as you go into labor, you decide you want a different hospital that has a midwife group instead.
I’ve heard this story countless times – although usually it happens a little earlier in the pregnancy.
While you have the freedom and autonomy to choose your medical provider and setting at any point, I recommend listening to your gut and allowing yourself to take action in switching earlier rather than later.
It’s helpful (and sometimes absolutely crucial) for your birth team to have all of your background information and to be familiar with you. If you show up during labor, you’re going to have a lot of questions to answer first – which isn’t very relaxing or reassuring.
Ideally, you’ll notice in your first six months how comfortable you feel with your provider. If at this point you still are feeling tense for appointments, aren’t sure that your provider has the same outlook or goals as you do, or feel judged or rushed, it’s probably time to switch.
It’s not a big deal if you need to switch out some members of your birth team, but do it as early as you can. To have the best birth outcomes and most positive experience, it helps to feel really connected, safe, accepted, and supported by our birth team.
Those are hard things to accomplish if you just met this person.
Ultimately, listen to your gut and follow your intuition. Maybe your provider isn’t as available or reliable as you need. Maybe they seem dismissive of your goals or questions. Perhaps they just aren’t very warm in their bedside manner – or maybe they are but someone on their team isn’t and you have no way of knowing who will be there for the birth.
Are you overwhelmed with information yet? Let’s make it simpler.
THINGS TO REMEMBER WHEN CHOOSING YOUR BIRTH TEAM
- You need a birth team that makes you feel comfortable, at ease, safe, and supported so you can more easily and successfully transition into motherhood and the next phase of your life.
- Ask open-ended questions that will help you decide if this person is a good fit for you and your birth preferences.
- Seek people to be on your birth team who make you feel comfortable, safe, secure, supported, accepted, and empowered.
- Choose providers who have professional training that best fits your situation and needs.
- Shop around! Feel free to interview more than one person to make sure you have found the best person for your birth team.
- Pay attention to how your body is responding to the environment so you can choose a setting for your birth that makes you feel the most relaxed, safe, and stress-free.
- You can change your mind about who you want on your birth team at any point in your pregnancy, but earlier is better than later.
At Kalamazoo Therapy Group, two of our counselors that are passionate about working with moms and are trained in perinatal mental health are Broghan Coulson and Kelsey Nimmo.