Choosing a midwife is one of the most important decisions you will make during your pregnancy. Unlike a standard 10-minute hospital checkup, out-of-hospital midwifery care is built on deep relationship-building, mutual trust, and shared decision-making.
Here is what you can expect from out-of-hospital midwifery care, along with the exact questions you should ask during your initial consultations.
What Exactly Is “Out-of-Hospital” Midwifery Care?
Out-of-hospital care—whether you are planning a birth at home or at a freestanding birth center—focuses on the midwifery model of care. This model views pregnancy and birth as normal, healthy life events rather than medical conditions to be managed.
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- Longer Appointments: Prenatal visits typically last 30 to 60 minutes. Your midwife will check your physical health, but they will also spend time talking about your nutrition, mental health, fears, and preparation for parenthood.
- Holistic Monitoring: Midwives perform standard medical checks (measuring fetal growth, monitoring blood pressure, ordering blood work, and listening to the baby’s heartbeat). However, they emphasize natural wellness, prevention, and education.
- Continuous Labor Support: Your midwife doesn’t just show up at the very end to catch the baby. They, or a qualified assistant, will be by your side during active labor, monitoring both you and your baby safely throughout the process.
- Comprehensive Postpartum Care: Instead of waiting six weeks to see a doctor, out-of-hospital midwives typically visit you in your own home during the first week postpartum to check on your physical healing, emotional health, and breastfeeding journey.
Crucial Questions to Ask During Your Consultation
When you interview potential midwives, you are looking for a blend of clinical expertise and personal compatibility. Print this list or save it on your phone for your consultations:
Credentials & Logistics
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- What are your credentials (e.g., CPM, CNM, LM), and are you licensed to practice in this state?
- What does your fee include (prenatal care, birth, assistant fees, postpartum visits, supplies)?
- Do you work with an assistant or a second midwife at births? If so, will I get a chance to meet them during my pregnancy?
- What is your backup plan if you are at another birth or sick when I go into labor?
Practice Style & Philosophy
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- How many clients do you take on per month?
- How do you handle prenatal testing, ultrasounds, and gestational diabetes screening?
- What is your philosophy on the timeline of labor (e.g., what happens if my water breaks before labor starts, or if my pregnancy goes past 41 weeks)?
Safety & Emergencies
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- What medical equipment do you bring to a home birth (e.g., oxygen, anti-hemorrhagic medications, IV supplies, resuscitation gear)?
- Are you and your team certified in Neonatal Resuscitation (NRP) and CPR?
- What are your specific protocols for a hospital transfer?
- Which local hospital do you transfer to, and how do you handle the transition of care with the doctors there?
Postpartum Care
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- What does your postpartum care schedule look like? Do you come to my home for these visits?
- What kind of breastfeeding or lactation support do you provide after birth?
Trust Your Instincts
As you listen to their answers, pay close attention to how you feel in their presence. Do you feel heard? Do they answer your questions with patience and evidence-based facts, or do they dismiss your concerns?
Your midwife will be entering your private sanctuary during your most vulnerable and powerful moments. Choose the professional who makes you feel safe, respected, and completely supported.