Navigating Your Home Birth Journey: Key Questions to Ask When Choosing a Midwife in North Dakota
So you think you might want to have a home birth- now what?
Whether you feel drawn to a home birth because of the individualized care, you want to be the one making the rules when it comes to who is welcomed into your birth space, you want to avoid common interventions standard in hospital, or your cultural or spiritual beliefs, the next step in the process of deciding if this journey is right for you is to find a midwife.
Ideally, you’ll have more than one midwife to interview, but here in western North Dakota, finding just one midwife that’s working in your area can be difficult, so it’s important to be flexible in your search.
Why is it a good idea to talk to a home birth midwife before you’ve decided that you even want a home birth? Because in any decision-making process, it’s a good idea to talk to an expert or two, and if there’s anyone that’s an expert on home birth, it’s the health care professional that specializes in this birth setting.
How do you find a home birth midwife?
Due to overwhelming demand for out-of-hospital birth care, few North Dakota midwives have websites or active social media accounts, so it can be challenging to find your local neighborhood midwife on Google.
My recommendation is to reach out to any friends that have had home births to find out what provider they used. If you don’t know anyone that has had a home birth, find a local doula or doula community- doulas are excellent hubs of resources and information for local pregnancy and birth options. If all else fails, post in your local mommy group on Facebook.
A few things you should know about hiring a home birth midwife in North Dakota: home birth itself is not illegal.
However, there are no legal standards and no legal definition as to whom may call themselves a midwife. Literally anybody, regardless of their training or background, can put out a shingle and start attending births as a “midwife.” Whereas an OB or any other hospital-based care provider has to meet certain training and professional standards in order to be allowed to practice medicine, there are no similar standards in place for anyone practicing midwifery in the state of North Dakota.
Does that mean that all we have for midwives are sketchy, furtive creatures with hooked noses and warts, arriving at your house with their bundle of roots tied up in a poke, riding a broomstick??? HA. No. As adventurous as that sounds, we have several FANTASTIC professional, highly-trained midwives that cover the western half of the state, from Dickinson and Williston, to Minot and Bismarck, much more likely to make their rounds in a Subaru than on a broomstick. Midwives with years of training and experience in the home birth setting, knowledgeable in both traditional, holistic medicines and practices, as well as mainstream medications and methods.
The lack of licensure or legal recognition by the state of ND means that instead of the state approving of your choice of birth attendant, that choice is let entirely up to you. On one hand, this means you and you alone are responsible for vetting your midwife.
Note: regardless of state licensure, it’s always important to take responsibility for your choice of care provider, whether that’s an MD or a midwife, because licensure is only part of the picture when it comes to being an excellent care provider.
So how will you know if the midwife in front of you is the right one for you, someone you can trust with the life of yourself and your baby?
Before you seek out any care provider, it’s important to do some digging into your own beliefs, philosophies, and goals around birth and to use this as an anchor in connecting with the care provider that meshes with those goals.
The questions I’ve listed below do not have a right or a wrong answer. Rather, they help you ask the right questions that will inform your choices and the ultimate question: “Do I feel safe with this person as my care provider, during the most intimate, vulnerable experiences of my life?”
Psst…don’t worry about writing all of these questions down—there’s a handy printable download at the bottom of this blog post.
Credentials, Experience, and Training:
What training did you take to become a midwife?
What professional credentials and certifications do you hold?
How many home births have you attended?
Philosophy of Care:
Can you describe your approach to prenatal care and the birthing process?
How do you involve the partner or support person in the birthing experience?
Emergency Preparedness:
What emergency equipment do you bring with you?
How do you handle emergencies or complications during a home birth, and what is your transfer plan if necessary?
Are you certified in Neonatal Resuscitation Protocol? CPR?
How do you handle postpartum hemorrhages? Severe tearing?
Collaboration with Other Healthcare Professionals:
How do you collaborate with hospitals or medical professionals in case of a transfer or if additional medical support is needed?
Can you provide references from other healthcare providers?
Prenatal Care:
What does your prenatal care routine involve, and how often will we meet during my pregnancy?
How do you address routine testing, ultrasounds, and other standard procedures?
Home Birth Logistics:
Can you walk me through what a typical home birth experience is like under your care?
What supplies should I have at home for the birth, and what do you provide?
Postpartum and Newborn Care:
How do you handle newborn screenings? Do you submit state birth certificate paperwork?
How often will you visit in the days and weeks following the birth?
Insurance and Fees:
What is your fee structure, and what services are included in your fee?
Do you accept insurance, and if not, what payment options are available?
Client References:
Can you provide references from other clients who have had home births under your care?
Are there any testimonials or stories from previous clients you can share?
Remember, this is not just an interview—it's an opportunity to build a trusting and supportive relationship with your midwife. Feel free to share your own thoughts and experiences, and let the conversation flow naturally.
Choosing a care provider and a birth setting is a highly personal decision, influenced by your own past experiences, traumas, medical history, the birth stories of the family culture that surrounds you. There is no right or wrong choice. There are only choices and taking accountability for the choices that you make.