Questions to Consider When Choosing a Provider
What to ask an OB/GYN, nurse midwife, or community midwife before you decide who will care for you
Part 3 of 7A consultation is an interview, and you're the one doing the hiring. The provider you choose will be with you through months of prenatal visits, through labor and birth, and into those first weeks with your baby. You deserve to know how they think and how they practice before you commit.
These are the questions I've gathered from supporting families here in Wilmington. You don't need to ask every one. Pick the ones that matter most to you, write them down, and bring them along. If you're still sorting out which kind of provider fits you, start with my post Your Birth, Your Choice: Understanding Your Options for Care Providers.
How to Use This List
Choose your top questions
Star the ones that speak to your values and your birth preferences. A focused list leaves room for real conversation.
Listen to how they answer
Notice their tone as much as their words. Do they welcome your questions, or do they seem rushed or defensive?
Check in with yourself after
How did you feel walking out? Heard and respected, or brushed off? Your gut is good information.
Questions for an OB/GYN or Certified Nurse Midwife Practice
Most OB/GYNs and CNMs work in group practices and attend births in the hospital. That means whoever is on call when you go into labor will likely be at your birth, so you're really choosing a whole practice, not just one person. These questions help you get to know the group.
Philosophy and partnership
- What is your practice's philosophy of care?
- Do all the providers in your practice share the same style and philosophy?
- Do you work collaboratively with other types of providers?
- How does your practice feel about birth plans?
- Will every provider in your practice support my choices, even if my choice is informed refusal?
- What will your providers do, give me, or test me for without asking for my consent first?
Who will be at my birth
- How many providers are in your practice, and how is call scheduled?
- Will I meet every provider who might attend my birth?
In Wilmington, most group practices rotate you through each provider at your prenatal visits, so you have a chance to meet everyone before baby comes.
- Do all the providers follow the same practices and protocols?
- If your practice has both midwives and OB/GYNs, how do they work together? When would an OB step in?
- At what point in labor will the on-call provider be with me?
Prenatal care and policies
- What will my prenatal and postpartum care include?
Ask for a timeline of tests and procedures, so you can research each one before your visit.
- What are your practice's standard procedures?
"Standard of care" means what a hospital or practice usually does. It isn't always the same as evidence-based care, so it's worth asking what the research says, too.
- What protocols and practices will you discuss and offer at my 36 to 42 week visits?
- What is your practice's policy on due dates and induction dates?
- How often, when, and why does your practice induce labor?
- If my water breaks before labor starts, how long are you comfortable with me waiting before I come to the hospital? (Ask for the answer if you're GBS negative and if you're GBS positive.)
- When do you recommend I come to the hospital once I'm in labor?
Labor and birth
- What is outside your practice's scope for vaginal births?
- Is there anything that would risk me out of your care?
- If my baby is breech, is anyone in your practice skilled in vaginal breech birth if I choose it? If not, will you support my choice and give me referrals?
As of this writing, I don't know of any provider in Wilmington who supports vaginal breech birth.
- If I'm carrying multiples, will you support a vaginal birth and plan it with me, rather than relying on set policies?
- Do your practice and the hospital support eating and drinking freely during labor, with or without an epidural?
- Will your providers support me pushing and giving birth in the position of my choice?
- Will they use warm compresses on my perineum for support during pushing?
- What does your practice think about delayed cord clamping? Do all your providers practice it?
Support and outcomes
- How does your practice feel about me working with a doula? Do you recommend one?
If a practice hands you a list of "hospital-approved" doulas, ask a few more questions. A doula who works for or is contracted with a hospital may answer to that hospital first. A doula you hire yourself works for you.
- What is your practice's cesarean rate? Does it vary much from provider to provider?
If your provider is in a solo private practice, also ask:
- At what point in labor will you be with me?
- What percentage of your clients' births do you attend?
- Will you be away at any time during my 36 to 43 week window?
- Who is your backup provider?
- Does your backup share your practice style and philosophy?
- Will I meet your backup at some point during my pregnancy?
You're allowed to ask. You're allowed to keep looking.
A provider who welcomes your questions now is more likely to welcome your voice in labor.
Questions for an Out-of-Hospital Midwife or Practice
Planning a home birth or a birth center birth? These questions help you understand how a midwife works, who will be with you, and what happens if you need more support.
Credentials and team
- What are your credentials?
There's no one-size-fits-all credential for midwives, and there's a lot of bias against traditional midwifery. Ask about their training and experience, not just the letters after their name.
- Do you work in a solo practice, a partnership, or a group?
- If it's a group, how many midwives are in it, and how many are on call at all times?
- Who else will be with you to assist at my birth?
Availability
- How many births do you take each month?
For a solo midwife, four or more births a month means a higher chance she'll be at another birth when you need her.
- If you're at another birth when I go into labor, who comes in your place? How often does that happen?
- Will you be away at any point during my 36 to 43 week window?
You want the midwife or team you hired to be there, whether your baby comes early, after 42 weeks, or your due date shifts later.
Approach and philosophy
- How do you practice informed consent and informed choice?
- What are your specialties?
- What birthing traditions do you bring into your care?
- Do you work with plant medicines, herbs, homeopathy, or other modalities?
- What are your policies on due dates and induction dates?
- Are there situations you can't or won't work with?
- Can you put me in touch with past clients?
Safety and transfers
- What medical supplies do you bring to births?
- Are you current on your neonatal resuscitation certification?
- If my baby is breech, what resources do you have to support a vaginal birth?
- How often do your clients transfer to the hospital?
- If I need to transfer, what can I expect?
- What is your cesarean rate?
- If I risk out of your care, will you still come to my hospital birth as an advocate and support person?
Labor support
- Do you recommend I hire a doula?
Be cautious if the answer is "You won't need one, we provide everything." Most midwives don't arrive until sometime in active labor, and you and your partner may need a helping hand for many hours before then. If you don't have a partner, close friend, or relative to support you in labor, a doula can make a world of difference.
Numbers to Keep in Mind
When an out-of-hospital midwife shares her numbers, here's what I look for.
Around this range is a good sign.
Around this number is a good sign.
For a solo midwife, a reason to ask about backup.
Ask About Postpartum Care
Ask, "What is your postpartum care schedule?" A typical schedule from a home birth midwife looks something like this:
- Day 1
- Day 3
- Day 5 or 6
- Week 21 or 2 visits
- Week 3 or 4
- Week 6Final visit
Then ask, "If I have postpartum issues, will you come more often?"
"Yes. My assistant or I will come as often as you need, or I'll refer you to someone more specialized if your concern is outside my scope."
From the space I hold....
Asking questions isn't being difficult. It's how you build a team you can trust. Take this list with you, trust what you feel, and remember that you can change providers at any point if something doesn't feel right. If you'd like to talk through your answers or practice what to ask, I'm here.
Reach out to Christy