Tips for Choosing a Midwife

When you're pregnant and choosing care for you and your baby, you want a midwife who you can trust and build a solid relationship with.  There are a few simple steps and issues to think about when you’re choosing the best midwife for your family.

  1. Employed or private practice? In Australia, most midwives work in an employed capacity.  They may either work in a private hospital or a public hospital.  Midwives may also work in private practice.  “What is the difference?” I hear you ask.  Well, the difference is that if your midwife is employed by a hospital, you will not generally be able to interview and choose your midwife; rather, you'll be cared for by whichever midwife is rostered on when you birth your baby.  However, interviewing and choosing your midwife is very much a feature of your engaging a private midwife.  The benefits of choosing to have a private midwife include: you can choose your birth setting (most private midwives attend births at home and in hospitals), an eligible midwife meets an additional registration standard, so if you choose to have care with an eligible midwife, you are assured that your midwife has been assessed and educated to a higher standard; and your midwife will provide all of your care including ordering your tests and scans and also writing any prescriptions you may need.
  2. Finding a midwife: There are various ways of finding a midwife.  A new Directory has been established that lists eligible midwives to assist you to locate an eligible midwife in your area.  You may also choose a midwife because of referral or recommendation; or because of the options of care that the midwife is also to offer you.  if you are choosing a midwife based on recommendation, it’s important to interview your midwife and maintain an open mind: there is no guarantee that another's recommendations will be suitable for you.  If you are considering midwifery for your care, it’s really important to think about finding a midwife early in your pregnancy, as many midwifery options and private midwives book out early on.  Some women prefer to interview their midwife before they become pregnant.
  3. Skills and experience:  each midwife will bring different skills and experience, however every registered midwife meets the same standards of education in order to qualify as a midwife.  Eligible midwives meet an additional standard, and this can be checked on the AHPRA website: you can search for your midwife and see that they have a “notation” to indicate that they are an eligible midwife.
  4. Convenience Of all things, this is one of the least important considerations.  You may find that you are traveling to receive the care you need, and on reflection, women who do this say that it was worthwhile to travel, rather than settle for care that was close to home, but not necessarily meeting the woman’s needs.
  5. Choice of place of birth: If your pregnancy is normal and you are healthy, you might like the option of birthing at home.  Hence, you may like to choose a midwife who offers homebirth.  However, it is also important to seek out a midwife who can attend your care in the hospital, in the role of the midwife.
  6. Method of practice:  midwives working in employed continuity models (that is, employed by a hospital but working in a model such as caseload or midwifery group practice) will book their own clients and see those women primarily.  However, they share the care of the women with the other members of the group practice.  This means that the midwife who you book-in with may not be the same midwife who provides all of your care. There are also some private group practices where you are cared for by two or more midwives throughout your care.  The other option is to see a private midwife who undertakes to attend all of your care: these will usually be midwives working in sole practice, and these midwives have a smaller caseload to ensure that they are readily available to their clients.  It is worthwhile understanding what arrangements your midwife has in place for times when they are not available, and also to ask what percentage of their booked clients’ births they actually attend.
  7. Your gut feel: It is important that you feel a sense of confidence in your midwife, and that you feel a sense of trust and comfort with her.  You should feel comfortable asking questions, and letting her know what is important to you.  In my experience, your gut feel is your best indicator.

Melissa Maimann is an eligible midwife in private practice in Sydney.  One of the first eligible midwives in Australia, Melissa offers a range of care options for women.  Visit Melissa's website to learn more about her services.