Hello! I'm currently interviewing midwives for my pre-natal care and birth (due in March). One midwife that I really like is actually unlicensed and I was wondering if anyone has thoughts on that. She's been practicing for 10 years with a mentor and has had her own practice for another 2 1/2 years. She said she chose not to become licensed because she felt it placed restrictions on the care she can offer her clients. I'm in Minnesota where non-licensed midwives can legally practice, but other CPMs have recommended that I not go with an unlicensed midwife.

 

What's your opinion?

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I would ask if she carries drugs for bleeding issues, if not it would be a no for me. I would also ask about her neonatal resuscitation training as well. I am all for homebirth and think it is great, but sometimes bad things happen during birth and the right training and medication can make those complications just a small bump in the road and without it it can be deadly. If she has both of those and you really like her then I would go for it.
Exactly! Also, I would find out if she can come with you to the hospital should you need to transfer, i.e physician backup or at least a good working relationship with ER staff. It's really important to not end up being stuck alone in an ER because your midwife isn't able to accompany you for some reason.
My midwife is unlicensed, and she is amazing! I personally don't think licensing is an indication of a "better" midwife. I also live in a state where unlicensed midwives are legal, but they are not allowed to administer pitocin or any other medication. My midwife has been practicing for 15 years and has other methods of handling hemorrhage. She's trained and experienced in neonatal resuscitation, and I give her my complete trust when it comes to my safety and the safety of my baby. Instead of asking if she can administer medication, ask her how she would handle postpartum hemorrhage or other complications.

In 15 years of practice, my midwife has been able to stabilize postpartum hemorrhage without medication every time except once. That one time was last year when she was working side-by-side with a CPM who had pitocin and they were able to use it, and it was the worst hemorrhage they've ever seen. Many times when hospital transfer is needed, the midwife can seamlessly transition into the role of doula and go with you. As long as there's not a hostile environment between her and the hospital, she should be able to stay by your side even if your care is transferred to a doctor. The exception would be if you have a c-section and hospital policy only allows 1 person to accompany you.

Another thing you can ask is what kind of support or backup she has. My midwife works closely with other midwives. She always has 2 attendants with her at each birth (apprentices that are learning from her) and she has access to other midwives if she needs additional support. I think this support system is more important than whether or not she is licensed.
Thanks everyone for the great advice! I'm interviewing a couple other midwives but so far the first is still my favorite. It puts my mind at ease that licensure doesn't mean better/more qualified. Actually I asked CPMs I've interviewed and they said they really just got the certification to keep the law off their backs when it came to using oxygen or pitocin. They said apprenticeship is the more important learning tool. The unlicensed midwife told me that she brings oxygen and pitocin with her in case of an issue anyway, she said she's able to obtain it even though she's not licensed.

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