There are many different kinds of home birth midwives. There is no one-size-fits-all midwife. They can vary in their education, preferences, titles, some with licensure, and some without. So many variations to consider! There isn’t a midwife who is perfect for everyone, but there is a perfect midwife for everyone who desires to have one!
Before deciding on a midwife it is important to know and understand the different variations of midwifery, what your state laws are surrounding midwifery, what the possible midwife’s preferences are, how she approaches/ sees physiological birth, how she handles certain scenarios, what she might “transfer care” for, and if she is licensed or unlicensed.
Some have a paternalistic approach to birth. This means they feel they are the provider with training and they know best. You must do as they suggest or they will “drop” you or “transfer” you out of their care. Often times, not giving any sort of refund. As we know, most home birth midwives are paid out of pocket, anywhere from 1.5K-6K depending on location. Scary, isn’t it?! There are also midwives who support and practice autonomy in their prenatal/birth support. This is where they respect mother’s wishes and try to see to it that the mother’s birth goes HER desired way. Depending on which one you prefer, it is important to know which one she associates more with! If you want autonomy over your birth, you may not like a midwife with a paternalistic outlook on birth!
Licensed midwives are legally obligated to abide by certain laws. Some will bend these laws to support a mama, some refuse to in order to protect their license. If you look into these laws (which vary by state), you will find that SO MANY are silly regulations! Many are not truly valid reasons to “drop” a mother when the midwife is educated to handle the scenario. Know in advance, every reason your midwife might drop you for and if there will be a refund. Know what rules she is willing to bend for you. Which is the main concern, you or her licensure?
A midwife might drop you as a client, or transfer your care for the reasons stated below and then some. As you can see, some are necessary reasons to transfer care to a medical establishment. In the same token, you should see that many of these are not valid reasons to abandon a woman and her desired birth. Is your midwife willing to bend your states laws to ensure you get your desired birth? Will she be quick to “transfer” care to protect her career? Who is she there to serve?
– Breech baby at term
– pre-E signs
– prolonged rupture of membranes
– Maternal Fever
– Signs of fetal or maternal distress
– Birthing before 37w
– Being 10 days “overdue” – 42 weeks gestation
– Maternal exhaustion
– Low birth weight of baby (pp transfer)
– PP bleeding (pp transfer)
– Tears(pp transfer)
– Retained placenta (pp transfer)
– Anemic at term
– Elevated Blood pressure
– Position of baby
– Placenta previa
– Meconium stained waters when membranes release
– Stage 2 (pushing) for over 2 hours
– Epileptic episodes
– VBAC births
– Low platelets
– Active genital herpes
– Refusing vaginal checks
– Stalled labor
– Midwife personal family issues
– Overbooked of the month
– Personality/Relationship clash
Unlicensed midwives are Midwives who practice what is called “Traditional Midwifery”. The ancient art of Midwifery; the original practice of midwifery based care before the medical establishment stepped in and created laws. This was practiced before the medicalized OB practice became a thing. Traditional midwifery is not legal in every state, thankfully, there are “underground midwives” in those states that forbid traditional care. If you look hard enough, you can usually find one!
In my findings, Traditional Midwives are less likely to abandon women for irrational reasons such as fetal presentation, gestation, PROM, or carrying multiples. They are more likely to serve their clients in full! Their heart is likely in care for you, not the career and legal aspects.
Many of the greatest midwives that have been licensed for years, are turning in their licensing to practice traditionally due to the insane laws the medical establishment is placing on licensed midwives. Many of these laws are disservicing women, and midwives are waking up to see things for what they are.
Licensure is not always a good thing and having licensure is not always a bad thing! Just know whom you are inviting into your sacred space, on this sacred journey. Know what they are comfortable with. Will they have an issue with you going over 42 weeks? Will they be a stickler on your iron level? Are they big on interventions (being “handsy”)? Are they more so hands off or do they medicalize every step of your labor and birthing? Know these things before laboring day! Know what kind of support you will receive before dropping a couple thousand dollars. As Becky Loney says, “If your midwife is driven by law, that’s exactly what she will deliver!”