I never put much stock in interviewing Birth Attendants with my previous births. The usual information on reasons to interview and questions to ask didn’t resonate with me as useful. Too often the usual sorts of questions are either too leading, or evaluate how willing to compromise a care giver may be rather than exposing their own thoughts and practices regarding the birth process. Knowing a practioner’s own beliefs is key to getting the birth experience you are looking for, because no matter how willing to compromise their own practices to your desires a practitioner may be, if or when something happens differently than you expect, the attendant will resort to her usual practices. This is not because she doesn’t respect your choices. This is because she has chosen her own standards because she was taught or believes that they are the best way. The care giver you want is the one that already believes and practices the way you do, so that any potential deviation from ‘normal’ will be cared for with that common frame of reference.

Recently when my sister became pregnant, and she was trying to decide between two very different options, I finally discerned an effective way of discovering the type of knowledge that will help a consumer evaluate the actual type of care a Birth Attendant gives and their beliefs and philosophy of birth. Using questions we developed together, she was able to make a clear decision based on information she gathered, rather than a feeling about a particular care giver, or suppositions at the beginning about what may happen at the end.

My list of questions is substantially shorter than most lists you will find. The important point may not even be the questions themselves, but the purpose behind each question and that they are all open-ended. I recommend you tell the practioner as little about yourself and your desires as possible before discussing these, to avoid having the Birth Attendant tailor her answers, either consciously or not, to your own desires. Keep in mind, however, that if you are interviewing a Birth Attendant in group practice, you may not be interviewing the individual who will actually attend your birth. You may want to follow up some questions with how it relates to the practice as a whole. There can be a widely divergent set of views on any particular topic in one practice.

1. What does a typical birth under your care look like? If you are as lucky as my sister, this one question will answer most of the usual questions about practice. It will also uncover the underlying philosophy of birth, to which you can decide how well it parallels your own beliefs. A practitioner who quickly launches into what may be done about this or that complication probably has a higher degree of expectation for complications than one who describes their practices or enumerates your choices.

2. How do you feel about doulas? Whether or not you desire to have a doula present, asking a practioner how she feels about them will tell you a great deal about her views of a woman’s need for support during labor or pain relief.

3. How do you feel about home birth/unassisted birth? If you are interviewing a hospital- or birth center-based practice, ask both questions; if you are interviewing a home birth practioner, ask the second. Both these questions help to define the level of trust a practioner has in the birth process. Again, it is up to you to evaluate whether their beliefs are in line with your own. Asking the question does not indicate your own level of comfort with either of these choices.

4. What are your personal statistics regarding…(cesareans, episiotomies, VBAC, breech, twins, or any procedure you are particularly concerned about)? Personal statistics are preferable to hospital statistics in determining the type of care a practitioner provides. You may desire to follow up with the hospitals statistics because hospital statistics can give you insight into the nursing care at a particular facility. How a nurse conveys the progress of labor to the Birth Attendant can have a great impact on the course of action or inaction decided upon by the Birth Attendant.

5. What are my options regarding…(Group B Strep, IVs, Rhogam, eating and drinking in labor, labor positions, birth positions, assisted deliveries, pain relief, or any other topic you are particularly concerned about)? This question should elicit the typical informed consent conversation a practioner would have with you concerning these particular topics, without the pressure of having to make a care decision at that point in time. The best thing would be to pick one or two that have not been previously addressed and that you may know a lot about. Determine how thorough the practioner discuss the options and pros and cons of each, and whether or not she leads you to a particular option.

6. When is the best time to cut the cord? The answer to this question sheds light on where the practioner believes the focus should be after birth, whether on the newly forming relationships, or on speedy completion of the birth process. Additionally, this question identifies the practices of a Birth Attendant during the third stage of labor. There is controversy over immediate clamping versus waiting for the child’s full transfusion of blood, with pros and cons in both camps.

These questions should facilitate a thorough and helpful conversation with your potential Birth Attendant(s). You may or may not have to use them all, or you may want to develop your own. Whatever you choose to do during your interview, remember that achieving satisfaction in the birth is largely a matter of choosing a Birth Attendant in line with your own beliefs and desires. You are purchasing the type of care they practice. Is it the care you want? If not, keep looking until you find what you want.