Questions to Ask Before Hiring a Midwife
A practical interview guide for families considering midwifery care — covering credentials, birth settings, on-call arrangements, and transfer protocols.
Choosing a midwife is one of the most significant decisions you'll make in your pregnancy. Whether you're planning a hospital birth with a certified nurse midwife or a home birth with a licensed midwife, the right interview will reveal far more than a credential list can.
Here are the questions that matter most — and what to listen for in the answers.
About Credentials and Experience
What is your credential, and are you licensed in this state? In the US, CNMs (Certified Nurse-Midwives) are licensed in all 50 states and can practice in hospitals, birth centers, and homes. CPMs and LMs are licensed in some states for out-of-hospital births. Verify licensure independently with your state's licensing board.
How many births have you attended, and how many in the past year? Experience matters. An active midwife attends births regularly and maintains sharp clinical judgment. Ask specifically about births similar to yours — first-time parents, VBACs, twins, or whatever applies to your situation.
Do you have hospital privileges? For out-of-hospital midwives, this is critical. If a hospital transfer becomes necessary, a midwife with established relationships at the receiving hospital can make the handoff far smoother.
About Birth Philosophy
How do you approach pain management? A good midwife will describe a range of options — water, movement, breathing, nitrous oxide, epidural access depending on setting — without steering you toward a predetermined approach. Be cautious of strong ideological positions about what birth "should" look like.
What is your cesarean rate, and how does it compare to the national average? For low-risk pregnancies, a thoughtful midwife should have a lower intervention rate than typical OB-led care — but not zero. A provider who has never recommended a cesarean is not necessarily a sign of skill; it may be a sign of poor judgment.
How do you handle disagreements with your clients about care decisions? You want someone who will give you their honest clinical recommendation, explain their reasoning, respect your autonomy, and document your decision if you decline a recommendation. Anyone who says they simply do whatever the client wants — or conversely, that they always know best — is a red flag.
About On-Call and Coverage
What are your on-call arrangements? Births don't keep business hours. Understand exactly who attends if your primary midwife is unavailable. Ask to meet the backup midwife before your due date.
At what point in labor do you join me? Some midwives arrive early in active labor; others wait until labor is well established. Make sure their approach aligns with what you want.
About Transfer Protocols (for Out-of-Hospital Births)
Under what circumstances would you recommend transferring to a hospital? A skilled out-of-hospital midwife should give you a clear, confident answer to this question — covering both emergencies (fetal distress, hemorrhage) and non-emergencies (prolonged labor, request for epidural). Vague or dismissive answers are a warning sign.
How far is the nearest hospital, and how long does a typical transfer take? For home births especially, geography matters. Know the answer before you commit.
Practical and Financial
What does your fee include? Confirm prenatal visits, birth attendance, postpartum visits, and any lab work or testing. Get a written contract.
Do you accept insurance, or do you provide superbills for reimbursement? Midwifery care is increasingly covered by insurance, but billing practices vary widely. Clarify upfront.
Also planning to hire a doula? Read: How to Choose a Doula
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