Independent Midwives

Who books an Independent midwife and why? What are the benefits of booking an independent midwife? Can they deliver my baby in hospital?

What is an Independent Midwife?
Independent Midwives are fully qualified midwives who, in order to practice the midwife's role to its fullest extent, have chosen to work outside the NHS in a self employed capacity, although we support its aims and ideals. The midwife's role encompasses the care of women during pregnancy, birth and afterwards.

Midwifery is the most securely regulated profession in the UK. All practising midwives must adhere to the Midwives' Rules which are enshrined in the 1902 Midwives Act of Parliament and subsequent amendments. All independent midwives are subject to yearly supervisory visits and equipment checks and must notify their NHS appointed Supervisor of Midwives of their "Intention to Practise" each April. In line with the requirements of our regulatory body, the NMC, we are required to ensure that our clinical practice is up to date and that our actions are within our sphere of competence.

If I transfer to hospital can you be with me?
Independent midwives are able to stay with you in hospital in case of transfer. However, it is difficult to gain honorary contracts within most NHS trusts (although there are a few exceptions), therefore it is unlikely that your Independent Midwife will continue to care for you, she can however stay with you as your supporter. If a caesarean section is needed, most hospitals will allow your Independent midwife into theatre with you and your partner (please check with your hospital as policy differs in each one).

If I transfer to hospital do I have to pay the full fee?
Yes. You have booked an Independent Midwife for midwifery care. Sometimes a transfer to hospital will become necessary and your midwife will have been acting properly and within her midwifery rules by detecting a problem and referring appropriately with your consent. There are never any guarantees in labour and birth and your midwife will have still worked many hours with you, been on call for you often for many weeks and supported you. If a transfer in labour had been needed, your midwife would have been doing her job properly by referring for medical assistance should deviation from normality occur.

If I book late do I pay the full fee?
Yes. Your Independent Midwife will often have to work harder within a short space of time when a woman books late. There is much behind the scenes work in the life of an Independent Midwife!

I have been told by my Consultant that I can't have a Homebirth, will you still take me on?
Independent Midwives support womens' choices. If a woman has made a fully informed choice then in most circumstances they will support you. Many Independent Midwives take on the care of women who are deemed "high risk" for example: women who have had previous caesareans, women with pre-existing medical conditions and women carrying twins to name a few. Your Independent Midwife will discuss all your options with you.

Independent midwives don't have insurance, what implications does this have for me and my baby?
The implications of Independent Midwives not having indemnity insurance is that in cases where a baby maybe born damaged there would be no financial recompense via an insurance company.

Until March 2002, it was possible to obtain some form of insurance but this became more expensive (Between £18,000 and £22,000 per midwife per year, more than most earn!). From March 2002, no insurance has been available at ANY cost in the UK. This problem is a global one affecting midwives in Australia, Canada and parts of the USA. Please see http://www.independentmidwives.org.uk/?node=737 more information about professional indemnity insurance.

Can I still receive NHS care?
Yes. You are fully entitled to all the blood tests and scans under the NHS. You are having independent MIDWIFERY care and this does not exclude you from NHS treatment.

How much do Independent Midwives charge?
As they are all self-employed, they are all able to choose what they charge but many are flexible in how you pay them. The going rate for an IM at the moment ranges from about £1800 to £4500 (approx) for the whole package of care - this will vary as to where you live in the UK. Most IM's will want to have received payment in full by the time you are 36 weeks pregnant.

Which Independent Midwife should I book?
It is usually best to have a consultation with an Independent Midwife prior to booking her. It is important to make the right choice as this is someone you will be having a close relationship with. Think about the qualities of the midwife/midwives you have met and who you will able to work with.

What emergency equipment do they carry?
Independent Midwives carry all the necessary emergency equipment to ensure that if a baby is born needing resusitation, this can be performed. For example: oxygen, suction, bag and mask. All midwives are trained in emergency resuscitation. Independent Midwives also carry emergency drugs in case a woman is bleeding heavily. We update ourselves on a yearly basis in emergency neonatal resuscitation and many of us have attended emergency skills workshops tailored for independent midwives attending homebirths.

It is a requirement that our equipment is checked on a yearly basis by a supervisor of midwives. As Independent Midwives, often working alone and mainly facilitating homebirth, we are very conscious that we need to be completely up to date with all the necessary skills should an emergency occur.

Please visit: http://www.independentmidwives.org.uk/?node=556