A midwife interview typically lasts 30 to 90 minutes and covers her clinical training, transfer protocols, equipment, fees (usually $3,000 to $6,500), birth philosophy, and your health history. Most midwives offer this initial consultation for free or $25 to $75. You should leave with a clear understanding of what's included in her care, what happens in an emergency, and whether you feel comfortable with her approach.
Interviewing a midwife feels different from a typical medical appointment because you're hiring her, not just being seen by whoever is on call. This conversation determines whether her clinical skills, emergency protocols, and birth philosophy match what you need. Here's what actually happens during that first meeting.
Most initial consultations last 45 to 60 minutes, though some midwives schedule 90 minutes if they include a full health history intake. You'll spend about half the time hearing about her practice and half asking your own questions.
Some midwives conduct initial interviews by phone for 20 to 30 minutes, then schedule an in-person meeting if both of you want to move forward. This saves time if her practice is full, she doesn't serve your area, or your health history puts you outside her scope.
You can bring your partner or a support person. Many midwives prefer this because they want to meet everyone who will be at the birth.
She'll ask about your health history, including previous pregnancies, surgeries, medications, and any conditions like high blood pressure or diabetes. This helps her determine if you're a good candidate for home birth or if you need specialist care.
She'll also ask about your current pregnancy: your due date, any complications so far, where you're receiving prenatal care now, and why you're considering home birth. If you're still early in pregnancy or not yet pregnant, she may ask about your general health and any risk factors.
Expect questions about your living situation, like whether you have running water, how far you live from a hospital, and who will be present at the birth. These aren't judgments, they're logistical factors that affect safety and planning.
Ask how many births she's attended, both as primary midwife and as assistant. A newly certified midwife might have 40 to 75 births under her belt, while an experienced midwife may have attended 300 or more.
Find out what her transfer rate is and why her clients transferred. The average transfer rate for planned home births is 10% to 25%, with first-time mothers transferring more often than women who've given birth before. Ask specifically about emergency transfers versus non-urgent transfers for things like prolonged labor or pain relief.
Ask about her training and certification. Certified Professional Midwives (CPMs) complete specific home birth training, while Certified Nurse-Midwives (CNMs) train primarily in hospitals but some attend home births. Ask if she carries malpractice insurance, which costs $5,000 to $15,000 annually and isn't required in all states but indicates a higher level of accountability.
She'll explain what she brings to a birth: oxygen, IV fluids, medications to stop hemorrhage, infant resuscitation equipment, and supplies for stitching tears. Ask to see her equipment if you want. Most midwives carry the same basic emergency supplies, but it's reasonable to verify.
She'll describe her protocols for common complications like slow labor, meconium in the fluid, or postpartum bleeding. You want specific answers, not vague reassurance. Ask what she does if bleeding exceeds a certain amount, or if the baby's heart rate drops.
Find out when she calls for backup or transport. Most midwives have clear guidelines: they transfer for certain blood loss amounts, specific heart rate patterns, labor that doesn't progress after X hours, or if you request it. Ask which hospitals she transfers to and whether she has relationships with physicians there.
Midwives typically charge a flat fee that covers all prenatal visits, the birth, and postpartum visits. This fee ranges from $3,000 to $6,500 depending on your region, with rural areas often less expensive than cities.
She'll break down what's included: usually 10 to 15 prenatal appointments, on-call availability from 37 or 38 weeks, labor support, delivery, immediate postpartum care, and 3 to 6 postpartum visits in the weeks after birth. Some midwives include birth pool rental, lab fees, and newborn screening. Others charge separately for these items.
Ask about her payment schedule. Many midwives ask for a deposit at hiring ($500 to $1,000), then monthly payments, with the full balance due by 36 weeks. Ask what happens if you transfer to hospital care before labor, most midwives refund a portion. Also ask if she bills insurance directly or if you pay upfront and seek reimbursement yourself.
Total fee for all prenatal, birth, and postpartum care
Source: MANA 2023, Regional Midwife Survey Data
She'll describe her general approach: does she actively manage labor with frequent exams and position changes, or does she take a more hands-off approach? Neither is wrong, but you want alignment with what you're hoping for.
Ask about her views on common interventions. Does she routinely do cervical exams, or only when there's a specific reason? Will she break your water to speed labor, or wait for it to happen naturally? Does she cut episiotomies, and if so, when?
Discuss pain management expectations. Home birth means no epidural, but ask what comfort measures she suggests: water, position changes, her experience with unmedicated labor. If you're worried about pain, say so. Her answer will tell you whether she's someone you can be honest with.
Ask about her backup system. Who covers if she's at another birth, sick, or on vacation? Will you meet her backup midwife before labor? Some practices have partnerships where you meet all the midwives, while solo practitioners have backup arrangements with other midwives you may never meet until labor.
Find out when she wants you to call during labor and when she'll come to your home. Most midwives come when you're in active labor (contractions every 3 to 5 minutes, lasting 60 seconds, for at least an hour), but policies vary. Ask if she sends an assistant or apprentice first, or if she comes herself.
Discuss postpartum visits. Most midwives visit you at home within 24 to 48 hours after birth, then again around day 3 to 5, and at least once more before six weeks. These visits include checking your bleeding and healing, evaluating the baby's weight and feeding, and doing newborn screening if your state requires it.
Pay attention to how she answers difficult questions. If you ask about emergencies or complications, does she give you straight information or brush off your concerns? You want a midwife who respects your questions, even the worried ones.
Notice whether she listens. Does she interrupt you, or does she let you finish? Does she ask follow-up questions about your specific situation, or give generic answers? A good midwife treats you like an individual, not a walking uterus.
Trust your gut about the relationship. You'll be calling this person at 2 a.m., letting her into your home during the most vulnerable hours of your life, and relying on her judgment in an emergency. If something feels off, even if you can't name it, keep interviewing other midwives.
Bring a list of your most pressing questions about emergency protocols, costs, and birth philosophy. Take notes during the interview because you'll likely talk to multiple midwives and details will blur together. If you leave the interview feeling heard and confident in her clinical skills, that's a good sign. If you feel dismissed or unclear about her emergency procedures, keep looking.