Selecting a Midwife

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Kelly Hamade, CNM

Kelly Hamade, CNM

Q: I am 37 and considering having a midwife deliver my first child and would like to know how best to select one that is a good fit for me and my husband. What questions should I ask them?

Kelly Hamade is a Certified Nurse-Midwife with OBGYN-North and Natural Beginning Birth Center in Austin, Texas. She has 3 children, 2 born at home and 1 in the hospital. 

A: Choosing a health care provider during pregnancy is a big decision. As with most things, one size does not fit all and it is always a good idea to weigh your options carefully. When considering a midwife, you should be aware that there are different types of midwives and their scope of practice, experience and education may vary. Midwives also attend deliveries in a variety of settings including home, birth center and hospital. Many work independently while others are employed in a group practice.

As you interview prospective midwives, some general points to consider include her training, education and experience, options for location of delivery (home, birth center or hospital), if they share an office rotation or call schedule with other providers – can you meet the other providers, insurance coverage and fees. You might also ask about requirements for prenatal childbirth education, length and frequency of prenatal visits, pain-management options for delivery and follow-up care after delivery. Discuss your desires surrounding your pregnancy and childbirth experience and inquire about their philosophies.

Childbearing women who are under a midwife’s care generally have normal pregnancies without complications. Midwives are trained to recognize complications and variations of “normal” and often collaborate with other providers such as obstetricians, maternal-fetal specialists, chiropractors, massage therapists and lactation consultants. Talk with your prospective midwife about your risk factors. During the interview process, you may wish to disclose your age and any other concerns that may impact your pregnancy and labor. Inquire about any relative policies, protocols or guidelines that may affect your care. You may wish to research your options for genetic testing and find out which tests are offered, and which are recommended based on your age. Additionally, what other types of prenatal tests are offered or recommended based on your circumstances? Ask which conditions you are at increased risk for and how you will be screened. Find out the midwife’s policy in the event that a high-risk condition develops during your pregnancy, delivery or post-partum period. Are there other providers in their practice that are available to co-manage those complications or would you need to transfer to another group? Good luck and best wishes on your journey!




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