Birth attendants often claim that their high cesarean rate is due to their clientele - that
they provide care for a lot of high-risk clients. This analysis shows that:
Among lower risk women, likelihood of cesarean delivery varied between 8
and 32 percent across hospitals.
Among higher risk women, likelihood of cesarean delivery varied between 56
and 92 percent across hospitals.
Hospital variability did not decrease after adjusting for patient diagnoses,
socio-demographics, and hospital characteristics.
This shows that practice variation in cesarean rates is real, substantive, and not just a
reflection of the mother’s risk level.
Here are the questions my partner and I went in with - grouped by subject.
There are many others which came up from these. I will put together the
list of books I used around the process of selecting a midwife for my homebirth
and post them to this thread as well.
What is your general philosophy about pregnancy and birth?
Do you let us do whatever we want during labor? (Food, positions, water,
What is your education and training as a midwife?
How many years have you been practicing?
Are you a mother yourself? How old are your children now?
How were your babies born?
Do you work alone or with a partner or assistant? If you work with someone,
what is their experience?
Do you participate in a local midwife peer review group? How many
meetings have you attended in the past year?
How many births have you attended as the primary caregiver?
What is your experience with breech births? How many have you attended?
What is your experience with twins? How many have you attended?
How many births are you attending now? Do you have a maximum, and how do
you manage to avoid too many commitments?
If I am planning a home birth, do you come to my home any time before I
go into labor? Do you provide supplies or literature to help us prepare?
How often will I see you? What do your checkups consist of?
What are your guidelines concerning weight gain, nutrition, prenatal vitamins,
and exercise? What are your standards for pre-eclampsia?
Do you require that I take a childbirth education class? Do you teach such
Who takes over for you if you go on vacation or get sick?
Hospital and Obstetrician
Do you attend births in a birthing center or hospital?
How do you handle emergencies? Under what circumstances would you transfer?
How many women whom you have attended have had to go to the hospital?
Would you stay with me in the hospital?
Do you require that I see a physician during my pregnancy even if everything
is all right?
Do you have guidelines or restrictions about who can give birth at home?
What kind of equipment do you bring to a birth?
Are you permitted to administer any drugs during labor?
How many people are allowed to be around?
When should I call you after my labor begins?
Do you wait until the cord has stopped pulsating before it gets cut?
Will you allow my partner to be as active at the birth as he desires?
How much time do you allow for the delivery of the placenta?
What are your fees and what do they include?
Can you submit your charges to my insurance company?
What payment arrangements do you make?
Have you ever had to resuscitate a baby?
Do you examine the baby after birth?
Do you give eyedrops or shots to the baby?
Do you have a pediatrician you work with or recommend?
Will you help me with breastfeeding?
How do you feel about circumcision?
How often do you come to see me after I give birth?
Do you provide or know of anyone who will help new mothers after birth?