Studies into homebirth safety indicate that delivering at home can be a safe option for low risk mothers. But the key to a successful homebirth is a good, competent midwife. What kind of midwife should you choose, and what kind of questions should you ask before hiring her?
Before saying anything else, it is very important to acknowledge that different countries have very different midwifery systems. Depending on where you live and how midwifery is regulated, you may be able to choose from a large pool of competent midwives or only have access to "granny midwives" with no real medical knowledge and no professional education.
In the United States, you'll find several types of midwives. What midwife can attend a homebirth varies from state to state. There are roughly three categories, which are:
- Certified Nurse Midwife, also known as CNM. This kind of midwife is one you'll find in every hospital. They have a nursing degree and then went on to specialize in midwifery. They attend a large number of births as part of their training process. Natural birth advocates sometimes see this kind of midwife as too medically-minded. They do have solid training, and you may ask them how long they have been delivering at home, what complications they have dealt with, and whether they work with a back-up OB.
- Certified Professional Midwife. This kind of midwife goes through training organized by other midwives, has to observe and attend a smaller number of births, and may be an apprentice with a more experienced homebirth midwife before setting up her own practice. Before you hire a CPM to attend your homebirth, ask her not just how long she has been in business, but also how many births she actually attended. We advise you question a CPM rigorously about her experience, because a newly certified midwife may have been at as little as 20 births and have seen no complications (such as postpartum hemorrhage or even meconium in the amniotic fluid), meaning she doesn't know how to handle them.
- Lay midwives are midwives with no formal training, who may have learned her skills from a senior midwife in an apprenticeship. Because they are not regulated, you'll have difficulty ascertaining their skill level. A good tip is to Google her name to see what other people say about her but still, handle this one with caution. Would you hire a plastic surgeon, or even an interior designer, without knowing how skilled they are?
Also see Scared of giving birth? Tips to cope with labor if you are an expectant mom.