How to Choose a Home Birth Midwife: A Step-by-Step Process

Author: Igel Cudiera

No checklist can guarantee a particular birth outcome, and a home birth plan can change as pregnancy goes on. A careful selection process helps you understand what a midwife offers, what they'll ask of you, and what happens if plans need to change.

The steps below follow a practical order, from finding licensed midwives to making a final decision. You can use them alongside the interview checklist at the end.

Before You Start: Is Home Birth the Right Setting for You?

Choosing a midwife and choosing a birth setting are connected decisions. Professional organizations view planned home birth differently, and it helps to know where they stand.

The American College of Obstetricians and Gynecologists (ACOG) states that it "believes that hospitals and accredited birth centers are the safest settings for birth," while also affirming that "each woman has the right to make a medically informed decision about delivery." The American College of Nurse-Midwives (ACNM) states that for the essentially well woman with a healthy pregnancy, "childbirth with qualified providers can be accomplished safely in all birth settings, including home, birth center, and hospital."

The American Academy of Pediatrics (AAP) "does not recommend planned home birth," while recognizing that "women may choose to plan a home birth."

ACOG and ACNM emphasize similar building blocks: careful assessment of who is a good candidate, a qualified attendant, and a working plan for getting to a hospital if needed. If you're still weighing your options, our comparison of home birth vs. hospital birth covers the evidence in more detail.

Step 1: Find Licensed Midwives Who Attend Home Births

In New York, only a person licensed or exempt under the state's midwifery law, or authorized by another section of law, may practice midwifery. The New York State Education Department (NYSED) confirms that licensed midwives may practice in "clients' homes," as well as hospitals, birth centers, clinics, and offices. Licensed physicians may also attend births.

Not every midwife attends home births, so look specifically for midwives or practices that do, and ask whether they serve your neighborhood. Useful places to start include:

• Recommendations from friends, family, or other health care providers
• Professional organizations. NYSED's midwifery FAQ points families to the American College of Nurse-Midwives (ACNM) and the New York State Association of Licensed Midwives (NYSALM), which may help identify members.

NYSED notes that the State Board of Midwifery "cannot refer you to a practitioner," so you'll need to do the comparing yourself.

Certified professional midwives (CPMs) hold a national certification that is not a New York license. Bills to create a CPM license in New York (S5542 and A1125) were in committee as of October 2026 and have not become law.

Step 2: Verify the License and Credentials

Check the NYSED license record

Before you invest time in interviews, look up each midwife in NYSED's free Verification Search. Select the profession "Midwife (028)," then search by name or license number. NYSED's glossary explains that to practice in New York, a professional "must be licensed and REGISTERED," so check that the status reads REGISTERED and that the "registered through" date hasn't passed. The record also has an Enforcement Actions tab for any final disciplinary actions.

Our step-by-step guide to verifying a midwife's license in New York explains each part of the record and what to do if you can't find someone.

Understand the letters after their name

Midwives may list several credentials, and they aren't all the same kind of thing. In New York, "licensed midwife" is the state license, which certified nurse-midwives (CNMs) and certified midwives (CMs) both hold. Degrees such as an MSN or DNP describe education, not permission to practice. Our guide to midwife credentials in New York explains what each abbreviation means and where it can be checked.

Step 3: Ask About Training and Home Birth Experience

A license confirms that a midwife met New York's requirements. It doesn't tell you how much experience they have with home birth specifically. Ask:

• How long they have attended home births, and roughly how many
• Who else attends births with them, such as a second midwife or birth assistant, and what training that person has
• How they keep their emergency skills current, such as newborn resuscitation training
• Which neighborhoods they serve and how they get to births

There is no single right number. What matters is whether their answers are specific and whether you feel confident in them.

Step 4: Ask How They Decide Whether Home Birth Is Right for You

Ongoing assessment

ACOG states that "strict criteria are necessary to guide selection of appropriate candidates for planned home birth." Its Committee on Obstetric Practice considers "fetal malpresentation, multiple gestation, or prior cesarean delivery to be an absolute contraindication to planned home birth." ACNM describes the choice of birth site as an informed-choice process that weighs "potential risks and benefits of each available birth site," along with an "assessment of maternal and fetal health." Ask each midwife what criteria they use and why.

Plans can change

Eligibility isn't decided once. A pregnancy that's a good fit for home birth early on may develop a condition later that makes a hospital birth safer, and a labor that begins at home may need to move to the hospital. Ask:

• What conditions would lead them to recommend a hospital birth instead?
• At what points in pregnancy do they reassess?
• If you no longer qualify for home birth, what happens to your care, and to any fees you've paid?

Step 5: Explore Their Approach to Care and Communication

Home birth midwives differ in style, and fit matters. NYSED's consumer information describes licensed midwives as presenting "a full range of choices" and letting the woman decide what she wants "within the safe available options." In a consultation, notice whether the midwife explains options clearly and listens to your questions.

Topics to discuss:

• Prenatal visits: how often, where, and how long they last
• Monitoring in labor: how they check on you and your baby
• Pain relief: what comfort measures are available at home, and what happens if you want medical pain relief. ACOG lists the "need for pain relief" among common reasons for transfer from home to hospital.
• Your birth preferences: how they support them, and how decisions are made if something changes
• Communication: how to reach them between visits and in early labor

If physiologic birth matters to you, our article on physiologic birth explains what the term means and how midwives support it.

Step 6: Understand Backup, Consultation and Transfer Plans

ACOG names "ready access to consultation" and "access to safe and timely transport to nearby hospitals" among the factors it considers critical to favorable home birth outcomes. This step is where those factors become concrete.

Backup if your midwife is unavailable

Labor doesn't follow a schedule. Ask who attends your birth if your midwife is at another birth, ill, or away, and whether you'll meet that person beforehand.

Collaborative relationships and emergency plans

New York law requires every licensed midwife to have collaborative relationships with a qualifying obstetrician, a physician who practices obstetrics with hospital privileges, or a hospital that provides obstetrics. These relationships must cover consultation, collaborative management, and referral, and include "plans for emergency medical gynecological and/or obstetrical coverage." The law requires midwives to make information about these relationships available to their patients. NYSED adds that the patient will be provided "an educational document which includes plans for emergency medical, gynecological and/or obstetrical care."

It's reasonable to ask each midwife about their collaborating physician or hospital and to see their emergency plan.

How a hospital transfer works

ACOG reports that "the reported risk of needing an intrapartum transport to a hospital is 23–37% for nulliparous women and 4–9% for multiparous women." Nulliparous means giving birth for the first time. ACOG lists the most common reasons as lack of progress in labor, concerns about the baby's well-being (which ACOG calls "nonreassuring fetal status"), the need for pain relief, high blood pressure, bleeding, and the baby's position.

Ask which hospital they would go to, how you would get there, whether they come with you, and what their role is once you arrive. Our article on what happens if a home birth needs to transfer to a hospital explains the process in New York. If you live in an apartment building, our guide to home birth in a New York apartment covers access and transfer planning.

Step 7: Ask About Newborn and Postpartum Care

A home birth midwife cares for your baby as well as for you. The American Academy of Pediatrics (AAP) says every newborn, regardless of where they were born, "deserves health care consistent with" the care it outlines for babies born at home. Ask:

• What newborn checks and care they provide at birth
• How they handle newborn screening. New York's newborn screening program states that when a baby isn't born in a hospital, "the birth attendant is responsible for ensuring that a suitable specimen is collected."
• When they recommend your baby see a pediatrician
• How many postpartum visits they make, when, and how to reach them afterward
• Whether they help with breastfeeding or refer you to a lactation specialist
• Who files the birth certificate. Our guide to getting a birth certificate after a home birth in New York explains the process.

Step 8: Clarify Fees, Insurance and What's Included

Costs vary by practice, so ask each midwife for a written summary of what their fee covers. Questions to ask:

• What's included: prenatal visits, the birth, a second attendant, supplies, newborn care, and postpartum visits
• What isn't included, such as lab work, ultrasounds, or a birth pool
• Payment timing, and what happens to fees if you transfer care before or during labor
• Whether they're in network with your insurance plan or bill out of network

On insurance, NYSED's FAQ explains that under New York Insurance Law, insurance plans regulated by the state must include midwifery services for maternity care. Self-funded employer plans governed by the federal ERISA law are exempt from state law, so coverage varies. Confirm benefits directly with your insurer. Our guides to insurance coverage for home birth and Medicaid and home birth in New York explain what to check.

It's also worth asking about malpractice insurance. NYSED states that New York's Education Law does not require midwives to purchase it, so practices differ.

Step 9: Compare Your Options and Decide

After your consultations, compare each midwife's answers side by side. Consider:

• Clarity: Were their answers specific, or vague?
• Safety planning: Did they explain their criteria, backup, collaborating hospital, and transfer plan without hesitation?
• Fit: Did you feel heard? Do their philosophy and communication style match what you want?
• Practicalities: Do their service area, availability, and costs work for you?

If you can, interview more than one midwife. If something feels unclear, ask follow-up questions before you decide.

Home Birth Midwife Interview Checklist

Bring these questions to each consultation:

• Are you licensed and currently registered as a midwife in New York? What name and license number should I search?
• What national certification do you hold, if any?
• How many home births have you attended, and who attends births with you?
• How do you decide whether home birth is right for my pregnancy, and when do you reassess?
• What would lead you to recommend a hospital birth or a transfer during labor?
• Who is your collaborating physician or hospital, and may I see your emergency plan?
• Which hospital would we go to if I needed to transfer, and would you come with me?
• Who covers for you if you're unavailable when I go into labor?
• How do you monitor me and my baby during labor?
• What comfort measures do you offer, and what happens if I want medical pain relief?
• What newborn care do you provide, and how do you handle newborn screening?
• How many postpartum visits do you make, and how do I reach you afterward?
• What does your fee include, and what happens to it if my care transfers?
• Do you accept my insurance, and do you carry malpractice insurance?
• How do I contact you between visits and when labor starts?

Positive answers to these questions help you compare midwives. On their own, they don't establish whether home birth is clinically right for you. That depends on your health and pregnancy, assessed over time with your midwife.

This article is for general educational purposes and is not medical, legal, or insurance advice. Whether home birth is appropriate depends on your individual health and pregnancy, so talk with a qualified maternity care provider. Licensing rules, insurance coverage, and pending legislation can change; confirm current details with the New York State Education Department and your insurer.

Sources

• American College of Obstetricians and Gynecologists. Planned Home Birth (Committee Opinion No. 697). April 2017; reaffirmed 2026.
• American College of Nurse-Midwives. Planned Home Birth (position statement). December 2016.
• New York State Education Law, Article 140 (Midwifery), §§6951–6957. NYSED reprint. Accessed October 2026.
• New York State Education Department, Office of the Professions. Frequently Asked Questions for Midwifery. Accessed October 2026.
• New York State Education Department, Office of the Professions. Consumer Information for Midwifery. Accessed October 2026.
• New York State Education Department, Office of the Professions. Verification Search and Online Verification Searches (glossary). Accessed October 2026.
• American Academy of Pediatrics. Planned Home Birth (policy statement). Pediatrics. 2020.
• Wadsworth Center, New York State Department of Health. Newborn Screening Program: Frequently Asked Questions. Accessed October 2026.
• New York State Senate. Senate Bill S5542 (2025–2026) and Assembly Bill A1125. Accessed October 2026.