How to Interview Your OB or Midwife So Their Birth Philosophy Actually Aligns With Yours
Many women choose their OB or midwife the same way they choose a dentist.
“This is where my sister goes.”
“My best friend delivered here.”
“I already see this provider for Pap smears, so I guess they’ll deliver my baby too.”
And while that makes sense on the surface, birth is an entirely different specialty than routine gynecologic care.
A provider can be excellent at well-woman visits and still have a birth philosophy that doesn’t align with the kind of birth you’re hoping for.
In this post, I’m breaking down how to interview a birth provider, what questions to ask, and just as importantly what to listen for between the lines, so you’re not surprised late in pregnancy when your goals and your provider’s approach don’t match.
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Why Choosing a Birth Provider Requires More Intention
Routine gynecology visits are largely about disease screening and problem-solving- Pap smears, infections, hormone issues, contraception.
Birth, on the other hand, is:
Physiologic
Hormone-driven
Variable
Time-intensive
Dependent on patience and trust in the body
It requires respect for normal variation, patient autonomy, and shared decision-making.
So even a warm, kind, highly trained provider may still:
Be very intervention-heavy
Be uncomfortable with unmedicated birth
Have little tolerance for normal labor variation
If you don’t intentionally ask questions early, you may assume alignment only to feel blindsided at 38 weeks when routine interventions start being suggested.
Interviewing your provider is how you prevent that.
If You Have Specific Birth Goals, Interviewing Is Non-Negotiable
If you’re hoping to:
Avoid an epidural
Avoid induction
Avoid surgery
Have a physiologic, low-intervention birth
Then you must understand your provider’s philosophy before labor begins.
Asking, “Are you okay with me not getting an epidural?” isn’t enough.
Most providers will respond with something like:
“I support any kind of birth as long as it’s safe. My top priority is a healthy mom and baby.”
That statement sounds reassuring but it tells you nothing about how they practice.
Every provider believes they care about safety. What matters is how they define normal, and when they believe intervention is necessary.
Question #1: “Why Did You Choose This Line of Work?”
This is one of my favorite questions because people rarely lie about their origin story.
Ask:
“Why did you decide to become an OB?”
“What drew you to midwifery?”
Their answer often reveals what still shapes their practice today.
I once had a client planning a VBAC who asked her hospital OB this question. His response?
“I really love surgery.”
That’s not bad or wrong, but for someone actively trying to avoid surgery, that’s important information.
On the flip side, I’ve heard providers explain that they grew up witnessing animals give birth, were amazed by how little intervention was needed, and felt called to support God’s design.
That philosophy is going to show up in the delivery room.
Question #2: “What Interventions Do You Recommend for All Women?”
This question is revealing because any universal intervention tells you something important.
If a provider recommends the same intervention for every woman, it suggests they view birth as something that inherently needs management.
Examples might include:
Routine IV fluids
Breaking water at a certain dilation
Continuous monitoring for all first-time moms
That may be a great fit for some families.
But if you view birth as a normal physiologic process and want to avoid unnecessary intervention, this question helps you see whether your philosophies align.
You can also clarify:
“Is this your personal recommendation, or hospital policy?”
“Is there flexibility with this?”
Both answers matter.
Question #3: “How Do You Feel About Unmedicated Birth?”
Even if you’re unsure whether you want an unmedicated birth, this question is incredibly telling—because unmedicated birth is birth at its core.
Listen for whether they engage with it in one of three ways:
Celebrate it
Tolerate it
Quietly discourage it
Quiet discouragement often sounds like:
“Most women can’t really do that.”
“Birth is unpredictable, so don’t make a plan.”
“Just keep an open mind and don’t try to control things.”
Celebration sounds more like:
“If that’s your goal, we’ll help you prepare.”
“We encourage childbirth education.”
“We recommend doulas.”
A provider who truly supports unmedicated birth knows what increases the odds of success and actively encourages those supports.
Ask for the Numbers (They Matter)
These questions aren’t confrontational but informational.
Consider asking:
“What percentage of your patients give birth without an epidural?”
“What is your induction rate, and what are the most common reasons?”
“What is your cesarean rate for first-time moms?”
Providers should know these numbers or be willing to find them. Transparency matters.
If a provider is unwilling or defensive when asked, that’s valuable information in itself.
Ask About Labor Time Limits and Supportive Care
You can also ask:
“How do you define failure to progress?”
“How do you support freedom of movement and position changes?”
“How do you protect privacy and a calm environment?”
“How do you support physiologic pushing?”
Providers who think physiologically can answer these clearly.
If they can’t, it may indicate that labor is something they’re used to managing, not supporting.
Listen Between the Lines
Sometimes it’s not just what they say, it’s how they say it.
Pay attention to:
Their tone
Their openness
Whether they seem threatened by your questions
Whether they view you as an active decision-maker
If a provider dismisses your curiosity now, that dynamic won’t magically improve during labor.
You deserve a provider who:
Welcomes questions
Explains their reasoning without defensiveness
Respects your autonomy
Sees birth as something to protect and support, not just control
This Isn’t About “Good” or “Bad” Providers. It’s About Alignment.
You’re not interviewing to trap anyone.
You’re not being difficult.
And there aren’t universally “right” answers.
You’re hiring someone to steward one of the most sacred, vulnerable moments of your life.
Alignment matters.
Choosing the right provider is one of the biggest factors in whether your birth goals become reality.
Want to Go Deeper?
If you want more support navigating provider conversations, understanding your rights, and preparing for an autonomous birth in any setting, join the Autonomous Birth Workshop.
If this post helped you, consider subscribing to the podcast or leaving a review—it truly helps other moms find this information.
You deserve care that respects your body, your faith, and your role as an informed decision-maker.
