What Questions to Ask Before You Hire a Home Birth Midwife in NC
Choosing a home birth midwife is one of the more personal hiring decisions you'll ever make — this is someone who will be present for one of the most significant moments of your life. A good midwife expects to be interviewed, and a free consultation is the right time to do it.
Here are the questions worth asking when choosing a home birth midwife, and what to listen for in the answer.
"What's your training and certification?"
Not all midwifery credentials are the same, and it's worth understanding the difference. A Certified Nurse-Midwife (CNM) is a registered nurse with graduate-level midwifery education and national certification — and in North Carolina specifically, CNMs are the only midwifery credential licensed to practice independently. Other credentials, like CPM (Certified Professional Midwife), aren't licensed for independent practice here, though a CPM may be part of a birth team in a supporting role, such as a trained birth assistant working alongside a CNM. Ask directly what credential your provider holds and how that translates to their legal scope of practice in NC.
"Who else will be at my birth?"
Home birth is rarely a one-person job. Ask who else is part of the birth team — a second attendant trained in newborn resuscitation is standard practice, and it's worth knowing their name, credential, and role before labor, not meeting them for the first time at your birth.
"What happens if something goes wrong?"
This is the single most important question on this list. A responsible midwife should be able to describe, specifically, what would trigger a transfer to a hospital, which hospital they have a working relationship with, and how that transfer would happen. If a midwife brushes this question off or doesn't have a clear answer, that's a real warning sign — not the question itself.
"What's included in your fee, and what isn't?"
Ask exactly what's covered — prenatal visits, birth attendance, postpartum visits, newborn screenings — and what's billed separately, if anything (birth pool rental, lab fees). (We break this down fully in our blog article here)
"What is your experience with birth, and what is your philosophy when providing care?”
Experience matters—but for most families, how a midwife thinks about birth matters just as much as the number of births they’ve attended. Ask about their birth philosophy: Do they see birth as a medical emergency or a normal family event that sometimes needs medical support? How high‑ or low‑intervention do they aim to be, and what kinds of situations would lead them to recommend interventions or a hospital transfer? Their answers will help you see whether their approach to safety, autonomy, and overall care aligns with what you want for your home birth experience.
"How available are you during my pregnancy, and who's my backup if you're not available?"
Home birth midwifery is often a one-on-one relationship, which is part of its appeal — but you should know what happens if your midwife is at another birth when you go into labor.
"How many other clients do you take per month?"
This directly affects the depth of care you'll receive. A midwife with a deliberately small caseload is generally trading volume for more individualized attention — worth understanding either way.
"What does a typical prenatal visit look like?"
Home birth prenatal visits tend to run 40 minutes to an hour, longer than a standard OB appointment. Ask what's actually covered in that time, so you know what you're evaluating a fee against.
Looking for home birth care in Wilmington or Leland, NC? Ready to ask these questions yourself? Casey serves families in Wilmington, NC and within about an hour of Leland, NC.
About the Author Casey Hartell, DNP, CNM, WHNP, is the founder of Wild Moon Midwifery, providing home birth and women's health care throughout Leland, Wilmington, and throughout Brunswick and New Hanover Counties, NC. A former U.S. Navy nurse who deployed aboard the USNS Comfort, Casey completed her doctoral training at Georgetown University, with a concentration in Women's Health and Midwifery, and brings 4 years of hands-on birth experience — including two years at a freestanding birth center — to every family she serves.
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