12 questions to ask your midwife

Linda Balles, CNM

Obstetrics and Gynecology

Midwives, experienced members of the community who provide support and assistance during childbirth, have been around as long as there have been babies being born. Today’s midwives are trained health care providers who support and care for expectant mothers not just during birth but through pregnancy and the postpartum period as well.

Choosing a midwife can feel overwhelming. Certified nurse-midwife Linda Balles spoke with us on twelve questions to ask your midwife.

1. “What experience do you have? What are your qualifications?”

“In my case, I’ve been a practicing certified nurse-midwife for 26 years,” said Balles. “I hold a Master of Science in Nursing, I’m board-certified by the American College of Nurse-Midwives and I’m working on completing my Doctor of Nursing Practice Degree.”

Becoming a certified nurse-midwife involves a significant amount of education and certification. When speaking with a potential midwife, ask about their education and certification, as well as their experience.

2. “What is your philosophy on pregnancy and childbirth?”

“Midwives, generally speaking, believe pregnancy and childbirth are natural and deeply meaningful experiences,” said Balles. “Every woman deserves to be heard, respected and supported throughout her journey.”

The goal of certified nurse-midwives and midwives is to create a calm and nurturing environment where women feel empowered to make informed choices about their birth. This involves trusting the natural process of childbirth, while being willing and trained to intervene if necessary to ensure the safety and well-being of both mother and baby.

3. “What prenatal care services are provided here?”

“Midwives are highly qualified providers in women’s health, caring for women throughout all stages of life, including pregnancy, birth and beyond,” said Balles. “For my own office, we provide comprehensive prenatal care, following the same evidence-based guidelines recommended by the American College of Obstetricians and Gynecologists (ACOG). This includes regular checkups, lab work and monitoring the health and well-being of both mother and baby throughout the pregnancy.”

Midwifery practices may not always provide all services, and many do not provide ultrasounds but do maintain a working relationship with OB/GYN offices to coordinate ultrasound appointments.

Balles noted also that if a pregnancy becomes high-risk or outside the midwifery scope of practice, the midwifery team will work closely with collaborating physicians to ensure a smooth transition to that higher level of care.

“As always,” Balles added, “a midwife’s goal is to provide safe, personalized and continuous support for you and your baby throughout your pregnancy journey.”

4. “How do you handle pregnancies that go past the given due date?”

“If a pregnancy goes past the due date, midwives generally monitor both mom and baby to ensure everything remains healthy,” said Balles. “After 41 weeks, there would need to be an ultrasound to check on the baby’s well-being, including amniotic fluid levels and movement.”

Pregnancies that seem like they would go beyond 42 weeks may result in a recommended induction to help ensure a safe delivery for mom and baby. Different midwifery practices may vary, so it’s important to ask for specifics.

5. “What is your general response to high-risk pregnancies or complications during pregnancy or delivery?”

“Our midwifery practice can safely co-manage certain high-risk pregnancies, such as those involving high blood pressure, insulin-dependent gestational diabetes or fetal growth restriction, in close collaboration with Maternal Fetal Medicine specialists,” said Balles. “This team-based approach allows medical providers to work together on providing personalized care while ensuring both mother and baby receive the highest level of monitoring and support.”

When pregnancies become too complex or fall outside of a midwife’s scope of practice, the midwifery practice works with collaborating physicians to transition the expectant mother to a higher level of support.

While different midwife groups may have different policies, many will choose not to manage multiples or pregnancies where the expectant mother has had two or more prior cesarean births.

6. “Will I see a regular midwife who also attends my birth, or will there be a group where a different midwife may be present?”

“This depends heavily on the midwifery practice,” said Balles. “Our practice includes four full-time certified nurse-midwives who work closely together as a team. We encourage our patients to rotate visits and meet each of us during their prenatal care, so they feel comfortable with every midwife in the group.”

When it’s time for delivery, the midwife available will be the one on call to attend your birth. This way, expectant mothers can rely on receiving continuous, personalized care from a familiar and trusted team.

7. “Do you provide any postpartum care after birth? Is there breastfeeding support while starting my breastfeeding journey with my newborn?”

“Midwives generally provide comprehensive postpartum care after childbirth to support the mother’s recovery, and for new moms, their transition into motherhood,” said Balles. “Some midwifery practices do offer breastfeeding guidance in their office, but more extensive support is available through lactation counselors that your midwife can put you in touch with.”

Midwives want to ensure that you feel supported and cared for after birth, making the transition into the ‘fourth trimester’, or the first three months of the baby’s life, easier for both mom and baby.

8. “Do you assist a pregnant person in creating a birth plan?”

“Our office is happy to help you create a birth plan and discuss your preferences for labor and delivery, and that’s very much a usual part of your care,” said Balles. “During your prenatal visits, your midwife will review your options, address any questions you may have and ensure that your plan reflects your wishes while prioritizing safety.”

9. “What should I put into my birth plan?”

“A birth plan is a written outline that helps you communicate your preferences for labor, delivery and immediate postpartum care,” said Balles. “Every mother’s birth plan is a little different, and it’s an excellent tool not just for preparing for birth but also for sharing what is most important to you about your birth experience with your health care team in advance.”

Balles added that most birth plans include details like:

• Who you’d like to have with you during labor and delivery

• Your preferences for pain management (natural techniques, epidural, etc.)

• Positions or comfort measures you’d like to use during labor

• How you would like to handle monitoring, IVs or interventions

• Your wishes for newborn care (skin-to-skin contact, delayed cord clamping, breastfeeding, etc.)

It’s important to remember that a birth plan isn’t a rigid set of rules, it’s a guide. Labor and delivery can be unpredictable, so your health care team will follow your wishes as closely as possible while keeping you and your baby safe.

10. “At what point during pregnancy should you start working on putting together a birth plan?”

“You can begin thinking about your birth plan at any point during your pregnancy, but most women find it helpful to start putting it together in the third trimester,” said Balles. “By that time, you’ve had a chance to learn about your options, discuss your preferences with your midwife and feel more confident about what’s most important to you during labor and delivery.”

11. “How can having a birth plan in place help during labor and delivery?”

“Having a birth plan helps you feel more prepared and confident during labor and delivery. It lets you share your preferences, like pain management, who you want in the room and how you’d like to welcome your baby, with your care team,” said Balles. “This helps everyone understand your wishes and support the kind of birth experience you hope for, while staying flexible if things change for safety reasons.”

In the end, your birth plan helps by giving you the time and space to plan before the urgency that comes with labor and delivery. You’ll feel more comfortable heading into your birth when you know what to expect and that you’ve communicated your needs and wants with your midwife.

12. “What advice would you give to a mom-to-be before she sits down to put together a birth plan?”

“My advice to a mom-to-be is to trust your body and believe in your strength,” said Balles. “Every pregnancy and birth is unique, so try to stay flexible and open to how your journey unfolds. Surround yourself with people who make you feel safe, supported, and heard. Ask questions, learn about your options and take care of yourself, both physically and emotionally.”

Most of all, Balles emphasized that birth is not just about bringing a baby into the world, but about an expectant mom’s wonderful transition into motherhood.