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OB/Midwife Interview Checklist

When interviewing prospective obstetricians and/or midwives to find one with whom you feel comfortable, use the following checklist to keep track of their credentials and information, as well as the questions you ask and their responses.


Name: _______________________ Credentials: ______________

Address: _____________________________________________

Telephone #: _________________ Fax #: _________________

E-mail Address: _________________________

Appointment Date: _____________

Time: _______________


Office

What type of practice is it (solo/group)?

sologroup

Is the office convenient?

yesno

What are the hours?

__________________

__________________

__________________

Are they flexible in accommodating your schedule?

yesno

Is the office staff and nurses friendly, courteous and helpful?

yesno

Is the waiting area child-friendly?

yesno


Caregivers

How long have you been in practice?

_____________________________________

_____________________________________


What additional training have you taken?

_____________________________________

_____________________________________


If solo practitioner, who will cover for you when you are not available?

_____________________________________

Phone #
_____________________________________


If a group practice, how often will I see the other doctors, nurse practitioners or nurse-midwives?

_____________________________________

_____________________________________


How available are you to answer my questions?

_____________________________________

_____________________________________


When is the best time to reach you?

_____________________________________

_____________________________________


How do I reach you if I need to?

_____________________________________

_____________________________________

Phone #
_____________________________________


Which hospitals and birthing centers are you affiliated with?
Can I choose?yesno

_____________________________________

_____________________________________

_____________________________________


Do you have an OB appointment checklist for me to follow?

yesno


Prenatal Care

What tests do you routinely perform during prenancy?

_____________________________________

_____________________________________

_____________________________________

_____________________________________


If I become a high-risk pregnancy, what changes might I expect in my prenatal care?

_____________________________________

_____________________________________

_____________________________________

_____________________________________


Do you consider vaginal birth after cesarean (VBAC)?

yesno

If no, why? ___________________________

_____________________________________

_____________________________________


Do you recommend childbirth classes?

yesno

Which ones?

_____________________________________

_____________________________________

_____________________________________


How do you feel about cord blood banking?

_____________________________________

_____________________________________


Will you support me if I choose to save my baby's cord blood?

_____________________________________

_____________________________________


Labor and Delivery

At what point in my labor will you or one of your partners meet me at the hospital or birthing center?

_____________________________________

_____________________________________


What routine procedures do you perform at the hospital or birthing center?

Enemas


_____________________________________

Continous fetal monitoring
_____________________________________

_____________________________________

IV's
_____________________________________

_____________________________________

Episiotomies
_____________________________________

_____________________________________


Do I have a choice of having these procedures done or not?

yesno

What do you suggest to help me manage pain during labor?

_____________________________________

_____________________________________

_____________________________________


Will you help me develop a birth plan if I choose to have one?

_____________________________________

_____________________________________


Additional Question(s) You Might Have:

_____________________________________

_____________________________________

_____________________________________

_____________________________________

_____________________________________

_____________________________________

_____________________________________

_____________________________________

_____________________________________


For Midwives

How many babies do you deliver on a average month?

_____________________________________


Who is your back-up obstetrician?

_____________________________________


Can you give me some examples of when you might manage my care jointly with the backup obstetrician or transfer me to one full time?

_____________________________________

_____________________________________

_____________________________________

_____________________________________

_____________________________________

_____________________________________


If I need a cesarean, will you stay with me during the procedure?

_____________________________________


References:

_____________________________________

_____________________________________

_____________________________________

_____________________________________

_____________________________________

_____________________________________


Overall

Did you feel comfortable with doctor or midwife?

yesno

Do you feel you can ask a question without feeling embarrassed?

yesno

Do you think you would feel comfortable calling the doctor or midwife in the middle of the night?

yesno

Did they take the time to talk to you?

yesno

Did you feel like they were rushing you through the appointment?

yesno

Did they answer your questions completely?

yesno


Final Comments:

_____________________________________

_____________________________________

_____________________________________

_____________________________________

_____________________________________

_____________________________________

_____________________________________

_____________________________________

_____________________________________

_____________________________________

_____________________________________


Rating

(Scale from 1-10:10 being the highest and 1 being the lowest)

_____________________________________


Decision
yesno


 




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