"You're braver than you believe. Stronger than you seem. And smarter than you think."

- Christopher Robin
Pooh's Grand Adventure

"Health is not simply the absence of sickness."

- Hannah Green

Your health is a very important factor when considering homebirth. The best candidate for homebirth is a woman who takes an active role in her health and surrounds herself with positive people who encourage her to maintain a healthy lifestyle.

The growing trend is to treat birth as a one-day event. But the months leading up to when you give birth are equally important. Many doctors, do not emphasize the importance of good nutrition during pregnancy or encourage the expectant mother to choose her food wisely.¹ According to Tom Brewer, M.D., author and pioneer in prenatal nutrition, "The complete exclusion of applied nutrition and basic physiology from clinical obstetrics in the United States continues unabated. There remains absolutely no significant recognition of the role of prenatal malnutrition, especially of protein-calorie (p-c) deficiency, in the etiology and pathogenesis of metabolic toxemia of late pregnancy."²

On the other hand, health is a particular focus of midwives' overall care. They promote the prevention or maintenance of the majority of prenatal complications like preeclampsia, hypertension, anemia and gestational diabetes, through diet and exercise. Midwives believe that when mother and baby are healthy there is far less chance of complications arising that would require medications, ventilators, and cesareans. Furthermore, their close monitoring throughout pregnancy would detect complications that could not be control or prevented through diet and exercise alone and the woman could be referred to an Obstetrician to deliver at the hospital.

Finding a good birth attendant is the cornerstone to a successful homebirth. Choosing a midwife is a very personal process. This woman will be with you during the most empowering yet vulnerable time of your life. She will be a person to whom you bare all. She will remain in a special part of your heart and in your memory of this special time in your life. She must be someone you feel safe with and trust.

The first step toward establishing trust is to understand the professionalism of today's midwives. The word "midwife" may conjure images of back woodsy obstetrics but today's midwives are trained professionals. As professionals, they are "skilled in their ability to assist childbearing women with the least amount of intervention, guard their privacy, protect their bodies and their babies," says Suzanne Arms, acknowledged leader of the natural birthing movement. Nearly all midwives in North Carolina have nationally recognized training and are certified.

Here are some things to ask your midwife candidate to determine if she is the right one for you.

Ask Your Prospective Midwife

 What is your educational background, what type of midwife are you (CPM, CNM, etc)?

 How long have you been a midwife?

 How many births have you attended? How many of these were at home?

 Have you had any mothers or babies to die? Why?

 Do you work with a backup doctor?

 Will you have other clients around the time my baby is due? What happens if you are with another client when I go into labor?

 How much do you charge?

 At what point during my labor will you come to my house?

 Will you have an apprentice? Will I be able to get to know her before my birth?

 Do you have equipment to resuscitate the baby in case it is needed?

 Are you certified in neonatal resuscitation?

 What emergencies could arise during labor? How are you prepared and equipped to handle them?

 How many prenatal visits do you recommend, what will happen during those and where would they be held?

 If I start my pregnancy low-risk, what will it take to put me in the high-risk category?

 Do you encourage your clients to have a doula? Is there a doula that you work with that you would recommend?

 How will you monitor the well being of my baby and me during labor?

 What will you do if my labor is progressing slowly?

 Do you do episiotomies and why?

 Are there any drug-free techniques you provide for pain relief during labor?

 How many of your clients have ended up at the hospital? For what reasons?

 What is the procedure if I have to be transported to the hospital?

 What is your approach to newborn care? What care is offered if the baby is healthy and normal?

 How long will you stay after the baby’s birth?

 How many postpartum visits will we have and where will they take place?

 Will you provide references?

NOTES
¹ Primary Care: Is There Enough Time for Prevention?By Kimberly H.L. Yarnall, MD, Kathryn I. Pollak, PhD, Truls Østbye, MD, PhD, Katrina M. Krause, MA, and J. Lloyd Michener, MD. April, 2003 Vol. 93, No. 4 American Journal of Public Health 635-641.
Found at http://www.nccrt.org/Documents/JournalArticles/NotEnoughTimeForPreventionAJPH303.pdf