There’s no shortage of advice out there about choosing a midwife: ask about experience, training, licensure, and backup plans. And yes, those factors absolutely matter. But here’s the truth most people won’t tell you: none of that matters if you and your midwife don’t share the same values.

Birth is not just a medical event—it’s deeply personal. It’s about trust, safety, and being seen and heard. So, while credentials are important, the real question is this: Does your midwife believe what you believe about informed consent, decision-making, and your right to bodily autonomy?

Because, if she doesn’t, no amount of letters after her name or glowing online reviews can fix that mismatch.

As a midwife myself, I’ve learned this the hard way. Many midwives do not actually share my values when it comes to informed consent. That realization shook me. But it also clarified why so many women walk away from their birth experiences feeling dismissed, pressured, or even traumatized: they chose a provider based on surface-level compatibility, not deep value alignment.

Let’s ensure that doesn’t happen to you.

Why Values Matter When Choosing a Midwife

You wouldn’t choose a therapist who doesn’t believe in mental health or a financial advisor who laughs at your budget goals. So why would you trust a midwife who doesn’t fully believe in your right to make informed decisions about your care?

Your midwife will be with you through some of the most vulnerable, powerful, and intimate moments of your life. If she sees herself as the final authority, rather than a trusted guide walking beside you, you’re not truly in partnership. And that lack of alignment has a way of showing up at the worst possible time.

Here’s what I mean by values:

• Does she believe in informed consent not just as a concept but in practice?
• Will she honestly present all your options, even the ones she wouldn’t choose?
• Does she support you in making decisions that go against her preferences if they’re based on evidence and your values?
• Will she opt out of your care because of your decisions, and if so, under what circumstances?

These aren’t minor details. They’re the foundation of the care you’ll receive—and the experience you’ll carry with you forever.

In the next section, we’ll dig into what informed consent means (and doesn’t) and then get into the questions you absolutely should be asking any potential midwife (or physician) before you hire them.

What Informed Consent Really Means (and Doesn’t)

Let’s be clear about one thing: informed consent is not just handing you a clipboard and saying, “Sign here.” It’s not rattling off a list of risks so fast your head spins or giving you a choice between two options that both feel like traps.

Informed consent means:

• You are given complete information about your options.
• The risks, benefits, and alternatives are explained clearly and honestly.
• You have time and space to ask questions, think it over, and decide what feels right for you.
• Your provider supports your decision, even if it’s not what they would choose.

That’s what it means to center the woman in her own care.

Now let’s talk about what informed consent doesn’t mean:

• It doesn’t mean subtle (or not-so-subtle) pressure to make the “preferred” choice.
• It doesn’t mean giving you incomplete or slanted information to steer your decision.
• It doesn’t mean punishing you with fear or guilt if you want to do things differently.

Here’s the reality: some midwives talk a good game about “supporting your choices,” but when you start asking real questions—about breech birth, gestational limits, or declining routine interventions—their tone shifts. Suddenly, the “options” come with strings attached.

That’s not informed consent. That’s conditional care.

Let’s talk about how to figure out if your potential midwife truly walks the talk.

Questions to Ask a Potential Midwife

The interview is not just about her. It’s about you—your values, your birth philosophy, and whether this person is going to support you when it really counts.

Here are some questions to help you dig deeper. And not just the questions but what to listen for in the answers.

1. How do you define informed consent?
   • Watch for: A thoughtful, values-based answer. Not just legal-speak.
2. Can you provide an example of a time when a client made a decision with which you disagreed? How did you handle it?
   • Watch for: Emotional maturity, respect for autonomy, and whether they supported that client regardless of their personal feelings.
3. Are there any situations where you would decline to continue care if a client made a choice you disagreed with?
   • Watch for: Honesty and clarity. You want to know this before you’re in labor.
4. How do you present risks and benefits when there’s more than one reasonable option?
   • Watch for: Balanced language, not fear tactics.
5. Do you routinely offer clients the option to decline or postpone procedures such as cervical checks, ultrasounds, or glucose screenings?
   • Watch for: Comfort with nuance and truly individualized care.
6. How do you handle it when a client declines something you recommend?
   • Watch for: Respect, not resentment. Providers who truly honor informed consent won’t take it personally when you exercise it.
7. How much time do you typically spend during prenatal visits?
   • Watch for: Enough time to actually discuss your options—not a rushed checklist.
8. Can I review a copy of your informed consent paperwork in advance?
   • Watch for: Willingness and transparency. If they seem cagey, ask yourself why.
9. What’s your philosophy on client autonomy?
   • Watch for: A deep understanding that you are the decision-maker, not them.
10. Where are your lines where you feel you would be forced to decline to care for me anymore, and how would you communicate that to me?
    • Watch for: An open and honest response to this question. Every midwife with any experience will know the answers to this question, so if they seem evasive, that is a red flag.

This isn’t about playing “gotcha” with your midwife. It’s about knowing where they stand before you find yourself at a crossroads.

Red Flags to Watch For

Sometimes, it’s not what’s said, it’s how it’s said. Some common red flags may indicate that a midwife doesn’t fully support informed consent, even if she claims to do so.

• Vague or evasive answers. Pay attention if she talks in circles when you ask about client autonomy.
• Uses fear to sway decisions. “If you don’t do this, your baby could get injured, sick, or die” is not informed consent. It’s coercion.
• Rigid protocols are presented as non-negotiable. Every practice has guidelines, but a provider who makes it sound like there’s only one way to do birth may not be willing to tailor care to you.
• Dismissive of your concerns or questions. If you feel like a burden for speaking up now, it won’t get better later.
• You feel like you’re being “managed.” Good midwives partner with you. They don’t try to control you.

If any of these come up in your consultation, it’s okay to walk away. You deserve a provider who listens to, respects, and trusts you to make your own decisions.

Credentials Matter Too: Understanding the Different Types of Midwives

While values and informed consent should be at the center of choosing your care provider, credentials still matter—and they matter more than most people realize. Not all midwives are trained the same way, licensed in the same manner, or permitted to perform the same tasks. That’s not just a technicality. It can directly impact your birth experience, especially if things don’t go according to plan.

Here’s a breakdown of the most common types of midwives:

• CNM (Certified Nurse-Midwife): CNMs are registered nurses with advanced graduate-level education in midwifery. They pass a national board exam and are licensed in all 50 states. In Texas—and many other states—CNMs are independent practitioners, meaning they do not need a doctor’s oversight to provide care. Depending on state law, they can prescribe medications, order laboratory tests and ultrasounds, manage common complications, and provide care in hospitals, birth centers, or homes. CNMs have the broadest scope of practice among all midwife credentials. If you want a natural birth but also want someone who can legally manage complications without having to transfer your care, a CNM gives you that option.

That said, most CNMs practice in hospitals or birth centers. In the Houston area, for example, only a handful of CNMs attend home births—I know of maybe four or five of us. That’s part of why home birth has become the primary domain of CPMs and LMs, and why CNMs sometimes get unfairly (and rudely) branded with the nickname “Medwives” by others in the field. The implication is that CNMs are too medical, protocol-driven, and quick to intervene.

Now, is that label accurate sometimes? Honestly, yes. But not always. I’m a Certified Nurse-Midwife (CNM) who has been exclusively attending home births for the last seven years. I trust birth. I believe in physiological labor. I know several other CNMs in the Houston area who share the same sentiment. So yes, the “Medwife” nickname exists—but please don’t assume it applies across the board. Like everything else in this process, it’s about the individual midwife, not just their credentials.

• CM (Certified Midwife): CMs are educated similarly to CNMs but do not have a nursing background. Only a few states license them, and their scope varies by location.
• CPM (Certified Professional Midwife): CPMs are trained specifically for out-of-hospital birth, usually through direct-entry programs or apprenticeships. Many are excellent at supporting natural birth. However, their scope of practice is more limited. In most states, they can’t prescribe medications or legally manage complications, and they often have to transfer care if things veer outside of a very strict low-risk model. In most states, they are not licensed to attend hospital births, and their ability to manage complex pregnancies is much more restricted.
• LM (Licensed Midwife): This is a state-specific title. In Texas, LMs are usually also CPMs, though licensing and training requirements vary from state to state.

Credentials don’t tell the whole story, but they tell part of it. Make sure your midwife is not only someone who shares your values but also someone whose training and licensure match the kind of birth you want and deserve.

What About Freebirth? Why I Don’t Recommend It

Some women, after negative experiences with the medical system or birth providers, begin to explore freebirth—giving birth without any trained professional present. Let me be clear: I believe every woman has the right to make this choice. Your body, your birth, your decision- period.

That said, I cannot, in good conscience, recommend it.

Birth is usually safe. Most of the time, things go beautifully. But when they don’t—when something shifts quickly and unexpectedly—you want someone there who knows what to do. A trained midwife isn’t there to control your birth; she’s there for the moments when your body or your baby needs help.

Over the years, I’ve had people ask me to participate in their freebirth in a “non-clinical” role—just to be present as an advisor or to step in if something goes wrong. I’ve had to say no every single time. This isn’t because I don’t respect a woman’s right to choose; it’s because there’s a line I cannot cross—not just to protect my own license, but for my ethical integrity and, more importantly, for the safety of that mother and baby.

Freebirth is a choice some women will make, and I’ll never judge it. However, I will not pretend it carries the same safety net as attending a birth. It doesn’t. And if I’m to discuss informed consent honestly, I must also speak honestly about this.

Final Thoughts: Choose the Midwife Who Shares Your Vision

Choosing a midwife isn’t like picking out curtains or deciding where to brunch. This person will walk with you through one of the most transformative experiences of your life—someone who will see you at your most raw, powerful, and vulnerable.

And not all midwives are created equal.

Some midwives are trained and licensed to manage a broad range of clinical situations. Others have a much narrower scope of practice. Some are required to follow strict protocols and physician oversight. Others, such as Certified Nurse-Midwives in Texas, are independent practitioners with the autonomy to provide fully individualized care. And while titles like “midwife,” “LM,” “CPM,” or “CNM” may all sound the same, the differences in training, legal authority, and risk tolerance matter more than most people realize.

But credentials aren’t everything.

Even more important than the letters after someone’s name is their commitment to your autonomy, your voice, and your ability to make fully informed choices. Unfortunately, not every midwife who claims to support informed consent actually lives it. That has become painfully clear to me recently in my own career. I’ve seen what happens when providers smile and nod, but fall back on fear-based policies or rigid, one-size-fits-all approaches.

So, ask the hard questions. Push for clarity. Pay attention to how your questions are received. Do they listen, or do they deflect? Do they invite conversation or shut it down? Your gut will tell you a lot; listen to it.

But let’s also be honest: choosing a midwife isn’t a one-way street. It’s not just about whether you choose her but also whether she feels she can safely care for you. This relationship should become a trusting partnership.  You need to trust her, and she needs to trust you.  Even midwives who are deeply committed to informed consent, like myself, have boundaries. We are licensed professionals, and we carry responsibility for your health, your baby’s safety, and the integrity of our practice. Sometimes, that means saying, “I respect your right to choose, but I can’t ethically or legally support that choice.”

That’s not a betrayal of informed consent. That’s informed practice. And any midwife worth hiring will be honest about where her lines are, just like you deserve to be honest about yours.

If you’re lucky enough to find a midwife who listens, respects you, walks beside you, not ahead of you, and stands firm in protecting what’s safe and ethical, hold onto her. That’s not just a birth provider. That’s a partner in one of the most important journeys of your life.

And every woman deserves nothing less.

—Stay Strong! Jaelin—

Additional Reading

• Midwifery for Expectant Parents: A Modern Guide to Choosing the Birth That’s Right for You by Aubre Tompkins
• Birth Book #1: How to Find the Best Doctor or Midwife, Have Less Pain in Labor & Be Fearless When Giving Birth by Sarah Blight
• The Right Midwife: This Is What You Should Look For When Choosing A Midwife – Practical Mommy
• What To Look For When Choosing a Midwife – Inspire.52

Note: Full disclosure: SHEis Online earns a small (very small) commission on any links in the article that take you to Amazon.

About the Author:

Dr. Jaelin Stickels, DPN, CNM, APRN, is a deeply passionate and highly skilled Certified Nurse Midwife, Women’s Health Nurse Practitioner, and the owner of Holistic Heritage Homebirth in Houston, Texas. With over a decade of experience, Jaelin has had the privilege of helping several hundred (over 700 as of 2024…) women welcome their babies into the world. In addition to her advanced practice licensure training, she has additional advanced training in twin and breech births, making her one of only a few with these skills in her area.  Jaelin approaches every birth with expertise, compassion, and a deep respect for the birthing process.

Jaelin’s journey into midwifery began with a profound love for supporting women through the incredible experience of pregnancy, labor, and postpartum. Since 2010, she has been dedicated to walking alongside families during these transformative moments, offering guidance, support, and care tailored to each individual’s unique needs. She is a big believer in informed consent and ensures clients are given the best evidence-based information to make the best decisions for themselves and their families.

Married to her high school sweetheart Ted (aka Chef Ted) since 1984, Jaelin is the proud mother of three grown children and the delighted grandmother of one amazing granddaughter. When she’s not assisting in births, Jaelin finds joy in going to the movies with her husband, quilting, and cherishing time with her family. Known by the other midwives in her practice (Holistic Heritage Homebirth) affectionately as the “Birth Hog,” she brings an unmatched dedication and enthusiasm to her work—no one loves birth quite like she does.

Read Jaelin’s Bio

Find out more about Jaelin’s Homebirth Practice (Holistic Heritage Homebirth) in Houston, TX