Education, support and advocacy for birth and wellness choices across Hawai'i

Acronym Definitions

*all acronyms represent the education and training of the provider and not their legal status to practice in the state of Hawai'i as a licensed provider

• CPM—Certified Professional Midwife
• CNM—Certified Nurse-Midwife
• CM—Certified Midwife 
• DEM—Direct Entry Midwife
• Doula - a Non medical support person during pregnancy, birth, and postpartum
• LM—Licensed Midwife
• LMT—Licensed Massage Therapist
• Montrice - offers support as a Doula but is also able to perform basic medical care under a primary midwife or doctor
• ND—Naturopathic Doctor
• RN—Registered Nurse

Finding and Interviewing Midwives

We recommend interviewing several to find one that is a good fit for you and your family.   Most Midwives work for a flat fee or have a sliding scale and you will likely be paying for your midwife without the assistance of insurance. You will want to make sure they offer the services, attitude, and philosophy you agree with. The ability to honestly express yourself and concerns to your midwife, or any health care professional, is central to being able to make an informed decision concerning your care. Make sure that you choose a midwife who you trust and who will be available when you need them, respect your opinions, values, and listen. The following are some suggestions for finding the best midwife for you.

• Ask friends and family for a recommendation.
  
• Midwives come from a myriad of training and experience backgrounds, so be sure to ask what certifications and qualifications she has earned.
• Check references.
• Ask questions about fees and services.
• Bring up any specific concerns about pregnancy.
• Discuss views on labor and childbirth in general.
• Midwives don’t administer pain medication; ask what techniques they use to help if you are finding it difficult to cope with the intensity of labor.
  
• Ask under what circumstances she recommends moving the homebirth into the hospital (this is called a transfer).
  
• If a transfer is recommended, will she go with you to the hospital and will she stay with you as long as she is needed to act as your advocate? 
• What routine labs does she perform?
  
• Does she prefer that you have dual care, meaning that you maintain a relationship with an OB practice throughout your pregnancy?
  
• How many days overdue does she feel comfortable with you going before she suggests induction? 
• Discuss your birth plan, particularly if it includes a water birth. Some midwives offer birth tubs at an additional fee.
• What part of the island is she coming from? How long would it take her to get to your home during peak traffic times?
  
• Find out her accessibility. How quickly does she typically call clients back? Is she available through email for non-emergency questions?
  
• How many births does she typically do in a month and how many other women does she have due around the same time as you?
  
• Does she have a backup midwife in case of an emergency?
  
• Often midwives have at least one assistant at the labor; if so, you will want to meet these other participants.
  
• Even if you are using a midwife for a homebirth, you may want to find an OB you and your midwife can consult with during the pregnancy if you so choose.
• Take a tour of the hospital so that you can feel more comfortable if the need for plan B arises.