Valerie Gommon Midwife’s Blog

The end of Independent Midwifery?

Posted on: May 2, 2012

Very sadly it looks fairly certain that Independent Midwifery will end in October 2013.  The Government and Nursing and Midwifery Council have for a long time been recommending that Independent Midwives should have professional indemnity insurance (negligence insurance) despite it not being commercially available in the marketplace i.e. insurers do not provide this insurance for midwives.  You can read more about the current situation here

An E.U. Directive is now due to come into force to implement this change and our current information is that it will be illegal for us to practice without professional indemnity insurance from October 2013.  This means that women will be denied the choice of choosing an Independent Midwife and we will be denied the choice of working independently and will be forced to stop practising or to return into the NHS.

The Independent Midwives UK organisation has been working tirelessly for years to find a solution and it is just possible that an eleventh hour solution will be found but this is now looking unlikely.

A group of midwives have formed an organisation called Neighbourhood Midwives and are working towards setting up an employee-owned social enterprise organization, to provide an NHS commissioned caseload midwifery homebirth service, based in the local community.  This may prove to be a workable alternative to Independent Midwifery but at present (if it comes to fruition) the service will only be able to accept “low-risk” women and this is of concern to all of us who have supported women with more complex situations, for example first time mothers, vaginal birth after a previous caesarean, twins, breech birth and women who are not deemed “low risk”.  The aim of Neighbourhood Midwives will be to extend their remit to include more women as soon as possible.

There is already a precedent for this type of care as One to One Midwives in Liverpool have already managed to set up a caseloading midwifery service (similar to independent midwifery in that a woman will care for a caseload of women throughout the whole of the pregnancy, birth and postnatal period) within the NHS.

It is a very sad time for midwifery and for women’s choice, but perhaps good things will come out of it, I certainly hope so.

17 Responses to "The end of Independent Midwifery?"

As a first time Mummy who had a homebirth, I strongly believe that women deserve choices.

I absolutely agree. Independent midwives offer the best service any birthing mother could possibly expect, and statistically, have proved they have the lowest infant mortality rates, compared with NHS . . . so how can the government justify this decision?

A very sad prospect and one which serves no-one well least of all women and their babies. So short sighted and oppressive. I would just implore you to carry on battling as there is too much to lose although I don’t need to tell you that do I?

For goodness sake! How could Women helping Women, by making their own choices, in sound body and mind be/go so wrong? Makes my blood boil!

As someone who had a ‘high’ risk pregnancy whose birth choices the NHS refused to support, I was so lucky to be able to access Independent Midwifery support. I had a wonderful homebirth which was positive in so many ways for me and my family. I can’t believe that choice too will soon be taken away from me. It’s a very sad time for women centred care.

Surely if the One To One mws have managed to secure intrapartum insurance then this is a starting point for negotiating something similar for IMs? Who is insuring them? What are their policy terms? Surely 121mws are helping their sisters in independent midwifery find a way to make things work having found a solution for their own practice? Sorry if I’m being too simplistic here…..

The One to One midwifery practice is a privately owned business and (I believe) as such holds some of it’s information confidentially. It is exciting that they have secured insurance, which shows that it is possible. IM UK members are continuing to search for a solution to our situation.

This has been the most awful witch hunt by the authorities. In an age when choice is at the forefront of the provision of health, it makes no sense to remove choice by those who elect to have an independent midwife. As someone who had a home birth with an independent midwife after an awful experience in an NHS hospital I feel it is like going into the dark ages. Why does the EU not consider making illegal obstetrics in private hospitals? There has been plenty of maternal and infant morbidity in that setting over the years – have they made an effort to look at it?

[…] So much attention has been given to this topic in the midwifery world recently, due to the dreadful situation in Hungary with Agnes Gereb. And of course there is much concern about the future of Independent Midwifery in the UK. […]

I really think this blog is too early – we should not be hanging up our banners and putting away our pens – there is loads of time for change to happen if the government feels there is an unshakable mandate. We should be writing our letters, organising our petitions, and generally jumping up and down and makinga noise. It is far too soon to write IMs epitaph – it is time to mobilise and shout.

Hi Ruth
Whilst I agree, and we certainly aren’t going down without a fight, but none of us are sure that it isn’t the end of independent midwifery. We’ve fought a long, hard fight and we are not convinced that there is anything that we can do to stop this EU directive.

It would be interesting to find out the reasons behind this proposed EU directive. Was it just thought up by a “little man in Brussels?” Although I can not comment on the rest of the EU, it is certainly not evidence based in terms of UK research on perinatal outcomes. The recent study ‘Birthplace in England’, found that for multiparous women, there were no significant differences in adverse perinatal outcomes between planned home births or midwifery unit births and planned births in obstetric units. So why not keep the choice?

It is because a rogue practitioner (not a midwife) caused harm to patients and because s/he had no indemnity insurance there was no redress for patients. Because of this a decision has been made that all practitioners must have negligence insurance. For every other profession this is not an issue because insurance is available. Unfortunately negligence insurance just is not commercially available for midwives because the work we do is “high risk”. You are quite right, it isn’t because of us per se … but any *one* claim would result in a pay-out of millions of pounds because it would need to pay for care for the rest of a child’s life and this makes the insurance commercially unviable.

The problem is that when it is posted across facebook as it has been then entices us to throw in the towel becasue the fight is over – it is the phrase ‘it is fairly certain’ which takes away all the energy. I think we need to be fearful but there are Mums out there who owe their lives and their sanity to you – give us a chance – indeed tell us again to write one more letter. Bye the bye got a reply from MP – sent blog saying this was so against the principles of the health bill ( which he supports as a tory). Bless him he will give it another push!

Modern midwifery is a very demanding job, which is why it requires the skills and knowledge of a university graduate. The BMid midwifery degree lasts three years and gives you everything you need to begin your career as a midwife. If you are interested in studying a BMid Midwifery University Degree then look no further than The University of Southampton, Hampshire where students will acquire work experience across a range of settings, including hospitals, birth centres and the wider community.

This situation is a real tragedy for midwives and mothers or would be mothers!! Surely the government and NHS could link independent midwives into the policies that are used for NHS staff.Labour wards are full really women need to have a choice about where and how they have their babies.

It is indeed a tr4agedy whilst Government and Commissioners are unwilling to act in women’s interests. One to one midwifery for instance is offering ‘independent midwifery care to NHS tarrif in Bradford – which gives us the best chance of IM care we have. however, the commissioners are refusing to pay the invoice when women choose this care. The solutions are all there – it is politicians and commissioners who need to act on them to enable them to happen for the sake of women.

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