Questions to ask before choosing a Doula or Midwife

Having the right support system surrounding you during pregnancy and childbirth is essential not only for your health, but also for baby’s. A midwife is a medically-trained professional who will serve as your primary caregiver during pregnancy, birth, and postpartum. A doula is someone who acts as a caregiver and advocate for you in addition to a medical professional. Here are a few things to think about when choosing one of these caregivers.

Questions to Ask Yourself

Before you search for the perfect caregiver, take some time to think about and clarify what you want from your providers and what your ideal experience would be (of course, labor and delivery can be unpredictable so remember that this isn’t like placing an order for a birth. Instead, it’s a statement of your best scenario.). You don’t have to have all the answers now, but knowing some of these details will help you find a caregiver that is a good match.

  • Pain Management. Are you open to an epidural or are you trying to avoid one? Have you looked into other pain management techniques like breathing exercises, massage therapy, or acupressure?
  • Delivery. How do you feel about procedures like episiotomies or the use of Pitocin before or after birth? Do you want to delay cutting the cord? How does your partner fit into this plan?
  • Visitors. Who do you want in the birthing room with you, including your partner, other children, or other relatives?

Questions for the Caregiver

The first questions to ask before you meet with a midwife or doula is about training and certifications. Midwives in Toronto must be licensed by the College of Midwives Ontario. Doulas do not need to be licensed, but you should check their education and experience before proceeding. Once you have those details worked out, here are some questions to ask to see if the caregiver is a good fit.

  • Experience. Ask how long she has been a midwife or doula and how many births she has attended. Were there any troubled births? What happened? How were they handled? At what point would a pregnancy or birth require further assistance from a hospital or obstetrician? (For example, what if the baby is presenting breech? What about going past your due date?)
  • Philosophy. There is no right or wrong answer here; you’re looking for someone whose philosophy of birth, prenatal, and postnatal care matches yours. Ask about pain management techniques, labor practices, thoughts on things like manually breaking the water and use of Pitocin, the need for continual or intermittent monitoring during labor.
  • Schedule. How many women do they attend to currently? What does the backup team look like? How often to patients typically see their primary provider compared to the backup team? How many patients are due around the same time you are? Can you meet with other providers beforehand?
  • Services. How many prenatal visits are provided? How many postpartum visits? Which tasks and services are provided? For example, is nutritional support provided? Childbirth preparation? Are routine screenings included, such as glucose and protein levels? Most of these specific questions would not apply to a doula but are essential for choosing a midwife.
  • Affiliations. Does the caregiver work with your chosen hospital? Has she attended births there in the past? What are her experiences with the rest of the medical staff at the hospital? Even if you’re hoping for a home birth, it’s best to be prepared for the unexpected.
  • Timing. At what point during labor will the midwife or doula join you? How long following birth will she stay?
  • Partners and Family. How does the provider feel about other people in the delivery room? Does this match your feelings? For example, will the provider be uncomfortable if your mother and sisters want to be present? What if you prefer a more private birth, will she be comfortable asking others to stay out?

After the Visit

Following an interview with a potential caregiver, take a few minutes to assess your feelings about the visit. Did you feel comfortable? Safe and secure? Did you feel heard and understood? Are your personalities a good fit? Some might prefer a high-energy caregiver to keep up the momentum while others need someone calm and steady. How was she toward your partner and other children? Do you feel comfortable calling to ask questions?

When choosing a professional to help with your pregnancy and birth, checking credentials and calling references is important. However, your feelings and comfort are just as relevant so don’t feel pressured to choose someone because your friend loved her or because she has excellent references if you’re not completely comfortable. This time is about you and your baby; make the choice that makes you happiest.