Will Independent Midwives Soon Be A Thing of The Past?
Due to the limitations of the NHS’s maternity services, many women have to rely on the support and services of an Independent Midwife (IM) to have the opportunity of a safe, positive pregnancy and birth.
IMs are midwives who have chosen to work outside the NHS in a self employed capacity.They are fully qualified midwives registered with the Nursing and Midwifery Council and look after women privately for both antenatal and postnatal care. Most IMs started their careers in the NHS but sought an alternative route where they could offer more individualised care compared to working within the NHS, where they were restricted by guidelines and protocols. Women are seen in their own home and IMs take the time to build a relationship with the woman supporting her through her pregnancy and birth. Approximately 90% of women cared for by IMs have home births but they also support women in birth centres and hospitals. IMs continue to look after the women and their babies for at least 28 days postnatally. This sort of personal and attentive service is sadly something not achievable on the NHS due to both the shortage of midwives and the large number of women they look after.
Do not be mistaken in thinking that IMs are only for the rich and famous. Most clients are average working class families who beg, borrow and save for this service. Many take out loans, sell their cars or arrange repayment schemes with their midwife. My husband and I hired an IM for the birth of our first baby last year after the NHS refused to accept my right to a natural birth. You can read our full birth story here: http://hampshirehomebirths.co.uk/birth-stories/koby-s-birth/
Like myself, IMs are not against the NHS service as a whole, but rather against the fact the NHS cannot provide the continuity of care and personalised service that is needed by women. The care I received by my IM was above and beyond anything we had ever experienced and worth much more than what we paid for it. Sadly the government is to make this indispensable service illegal as of October 2013.
The Government is currently enforcing EU legislation that will require all health professionals to have indemnity and insurance. At present, IMs cannot be indemnified or insured as there is simply no affordable insurance available for independent midwifery service, with annual fees being quoted at £80,000!! This is because the number of IMs is currently too small to enable the risk to be pooled and spread in a way that produces an affordable premium. In essences, the real reason behind why IMs cannot get insurance is due to the NHS’ shortcomings. An NHS Litigation Authority report in 2012 stated that £3bn was paid out due to mistakes made in maternity care in the past 10 years. Insurance companies fear that IMs may have the same shortcomings and thus will not take the risk and insure them.
The Departments of Health fails to see the necessity of IMs and instead wishes them to form social enterprises to negotiate contracts to deliver maternity services to the NHS. However this simply means all maternity services will be delivered by the NHS and thus takes away women’s right of choice of care. In no other area of medicine are you restricted to only NHS care. The government also fails to see that independent midwifery has significant public health benefits in terms of increased normal birth and breastfeeding rates and thus actually saves public money. Taking on independent status is also something which offers great advantages to midwives themselves, empowering them as frontline workers, to work closely with women and with more flexibility in their working lives – crucial if the current shortage of midwives from the profession is to be reversed.
Agnes Gereb an Hungarian midwife famously said that ‘the freedom of a country can be measured by the freedom of birth.’ Ironically this midwife has been under house arrest for over 2 years after flouting the Hungarian law banning home births and continuing to help women give birth in their own homes. If the UK government is allowed to get their way and ban IMs then will they also continue to follow Hungarian’s route of imprisoning highly trained medical staff because they wish to give women a right to choose how they birth their babies? I have no doubt that devoted IMs will practise illegally to help women birth how they choose. Women will risk their lives and their unborn child to have an unassisted birth and birth partners will assist in these births which is illegal in the UK except in emergencies. With the UK prison service already overstretched, do they have enough room for the midwives and birth partners that will flaunt the law in order to help give women the birth they want and rightfully deserve?
Just when we thought the government couldn’t destroy maternity services any further, the Department of Health has just launched a consultation on the legislation regarding this issue and they slipped one more surprise into the framework. Now ALL midwives, and that includes IMs and NHS midwives, will have their registration taken away from them should they not have insurance! It means that not only will IMs lose their registration but also NHS midwives between jobs; on extended maternity leave or family career breaks will too. The term midwife is a term you can only legally use if you are registered so any midwife who is not actively working in the NHS will no longer have a legal career title. This is ludicrous. If you don’t have car insurance do they take away your driving licence and say you’re a learner driver? Or if you don’t have travel insurance do they take away your passport and say you’re not a UK citizen? Of course not! So why then does the government think this is acceptable, especially in a country who founded an NHS system to provide high standard maternity care to all?
If we allow the UK to pass this notion then it’s only a matter of time before other private health professionals also have their statutory body’s insurance facility withdrawn in the same way and they too start losing their registration to practice. I for one would be devastated to lose my family’s chiropractor.
This is a tragic situation for women, babies and midwives and I fear that this will be repeated until all alternative medical treatment options are eradicated. Let your voice be heard on this topic by commenting on the consultation at http://www.dh.gov.uk/health/2013/02/indemnity-i/ or ask your MP to make a motion for the government to underwrite or subsidise an affordable policy so that midwives can remain self-employed and provide care outside of the NHS system. In addition to this, you can also join a peaceful protest for the right to ‘choose your midwife, choose your birth’ on Abingdon Green London on Monday 25th March at 11am. Lets not let the UK government make health care about finance rather than care and practice.