Birthing without fear: a fight to allow women the right to choose their caregiver

Back in my pre-children days I worked as an independent midwife. I had the privilege of looking after women throughout their pregnancy from the point at which they booked my care, right through to the birth of their babies and for six weeks afterwards. I loved the fact that I got to know the women I cared for and to be able to give them that continuity of care.

 

When Sophie was born, I was lucky to have two midwives that I knew look after me in labour. Two independent midwives that I had worked closely with; two women that were both colleagues and friends. To be able to birth my baby in my own home and feel completely safe and secure in the hands of two midwives who I knew and trusted completely was a wonderful experience.

 

It nearly wasn’t that way though. When I booked my independent midwives, I was aware that their ability to practice was under threat. At the time of my booking them, independent midwives were unable to obtain professional indemnity insurance. The NMC had threatened that unless they obtained it (easier said than done at the time) prior to a certain date, they would no longer be able to practice as midwives. That date was three days after Sophie’s due date. As a result, I also booked in with my local midwives for a home birth in case my own midwives were unable to attend me.

 

As Sophie’s due date approached I became quite anxious at the prospect of not being able to have my own midwives. I had no doubt that the NHS midwives would be good midwives and would provide good care in labour. However, they would be complete strangers to me. The thought of giving birth with strangers who did not know my wishes, did not know what was important to me and why it might be important made me very stressed. Thankfully, the NMC extended the deadline. Sophie arrived a day later and I was able to birth her with my chosen midwives in attendance.

Me in a birthing pool whilst in labour with my husband holding and supporting me: Birthing without fear - a fight to allow women the right to choose their caregiver

Independent midwives have since been able to obtain an indemnity arrangement. This was reviewed and risk assessed prior to use by lawyers and actuaries.  It seemed as though women’s choices were no longer under threat. This week though, the NMC have decreed that the cover that independent midwives have is no longer adequate. They have ruled that independent midwives are no longer able to provide midwifery care and support women in labour with immediate effect.

 

Independent midwives are fully qualified and highly skilled. They are experts in home birth and many of them are skilled at supporting breech birth too. There are many reasons why women choose independent midwives. For me, continuity of care and being able to have midwives that I knew and trusted was important. Some women chose independent midwifery care because they have had a previous traumatic experience on the NHS or because the NHS is unable to support them in their birth choices.

 

For women who have currently booked an independent midwife, to be told that they cannot be cared by the midwife they have come to know and trust must be utterly devastating. For some women, the prospect of birthing alone is preferable to returning to an NHS hospital.

 

Independent Midwives UK (IMUK) assert that the level of cover they have is adequate and meets legal requirements. As one of my former independent midwife colleagues puts it:

“We asked for clarification (several times), this is the answer we received…

‘We (the NMC) are unable to advise you about the level of cover that you need. We consider that you are in the best position to determine, with your indemnity provider, what level of cover is appropriate for your practice. You should seek advice as appropriate from your professional body, trade union or insurer to inform your decision. You need to be able to demonstrate that you fully disclosed your scope of practice and to justify your decisions if asked to do so.’

Thank you for your clarity NMC, we have obliged and did as you asked. Please tell me how you have now found the power to determine what is deemed as adequate?

I remain confused,

Yours sincerely,

A distraught IM and her devastated clients”

 

I would like to clarify here that I am not criticising NHS midwifery care in any way. Jessica was born in an NHS hospital with NHS midwives. My birth experience with her was a very positive one. I am passionate about fighting for the NHS. Jessica is here because of the wonderful care from the NHS. She depends upon the NHS for her continued survival. I received wonderful care with the NHS during my pregnancy with Jessica, her birth and her hospital stays afterwards. But I also firmly believe that women should have the right to access private midwifery care if they wish.

 

During my pregnancy with Jessica, I also received cared from my two independent midwife colleagues. They were incredibly supportive throughout a challenging and complicated pregnancy. Had I wanted it, they would have also helped provide emotional support during my labour with Jessica.  They were always there at the end of the phone if I needed them.   I was lucky to experience the best of both worlds: superb medical care from the NHS staff as well as the continuity of care and emotional support from my independent midwives.

 

If I choose to have a third child, I would want to book with independent midwives once again, even it was in addition to NHS maternity care. It makes me incredibly sad to think that this option may not be open to me.

 

Please take a moment to read and consider signing this petition to help allow women the right to give birth with the support of a skilled and qualified caregiver of their choice. Private healthcare is an option for other areas of healthcare – it should be a viable option with midwifery care too.

Mummascribbles

24 thoughts on “Birthing without fear: a fight to allow women the right to choose their caregiver

    1. Sorry Lucy – had the wrong link there. I’ve amended the link now so it should link to the petition page. Thank you for letting me know x

  1. A really well written post and you make a good case. Giving birth is such a big thing, whatever makes the mother feel more in control and comfortable at birth ought to be allowed if safe. #TwinklyTuesday

    1. Thank you Fiona. Safety is always paramount of course but to feel in control and comfortable makes such a huge difference x

  2. I am really shocked by this ruling, it seems such a shame – I know people who have had truly positive and empowering experiences because of their independent midwifery care. I think particularly people who suffer from anxiety or have had traumatic births in hospital in the past can find great comfort in the fact they have midwives that they know and who understand them. I did actually look into it for myself but decided I couldn’t really justify the expense- for while my birth with TM wasn’t amazing it didn’t traumatise me and both me and B are quite laid back about these things and we were lucky with the NHS care we received. I’ve opted to do a hypnobirthing course offered for free at my local hospital and am hoping that will give me a more positive experience this time round.
    I hope this decision is changed as it’s a real blow, especially to those women who are currently pregnant.

    1. Thank you for your comment Ellen. Having an IM can make such a huge difference if you’ve had a previous traumatic birth. Hope the hypnotherapy course helps you have a more positive experience – I used it second time around and found it helpful x

  3. This makes me so sad! I don’t know how they can even justify it? I hope everyone who reads this signs this petition! xxx

  4. This is really upsetting – for lots of women, having that continuity of care is so important and it’s something that an overstretched NHS just cannot provide. During my 4 hour labour, I was looked after by 3 different midwives (all of whom did an amazing job, and it didn’t overly bother me, but shows just how overstretched things are!). I completely agree that if a woman feels that being supported by someone they’ve come to know and trust is important, then that’s a birthing choice that should be supported. Off to sign the petition.

    1. Thank you Katy – the NHS is overstretched and it is such a shame that being able to have a choice outside of that system is being taken away. 3 midwives in 4 hours seems a lot – I’m glad that the care you received from all was excellent but as you say, it does illustrate how overstretched things are x

  5. This makes me sad too, women should have choices. NHS midwives are fab, but the think I really missed was seeing the same midwife each time, to be able to get to know them and go through the journey with them must be fab.

    1. For me, it was so reassuring to have that continuity and as a midwife, I found it much more rewarding to be able to be with a woman throughout her journey. Such a shame that it’s not more widely available and even less so now.

  6. As you know I had both my children at home and for all the reasons you listed above. It would have been my worst nightmare if I was told before the birth of my children I had to chance midwifes. At the time I think it would probably send me into a spiral of anxiety and fear!

    1. It’s such a horrible situation for the women who are currently booked with IMs who now can’t have them attend their births. It makes such a difference to have a known midwife. I do hope some solution can be found soon so that these women will be able to have their known midwives attend their births x

  7. Signed and just about to share on FB. Such a shame that the choices of women are likely to be limited.

    1. Thank you so much Sarah. It is such a shame – I do hope a solution can be found soon that helps keep women’s choices open x

  8. Oh goodness this is terrible, not just for the people who use independent midwives but for the midwives themselves, this puts their career under threat doesn’t it? How awful. I’ve signed the petition.
    Nat.x

    1. Thank you for signing Nat. As far as I’m aware IMs can still carry out antenatal and postnatal visits but not labour care – which of course is when their clients need them most. Such an awful situation for all concerned 🙁

  9. This sounds completely bonkers Louise and I can’t understand why the nmc has made such a daft decision. As you say, surely it is a woman’s right to use independent midwives, and surely anyone who does do that takes a little strain off of the NHS so its a win win. Why on earth would they make it so difficult?! Xx

    1. It’s crazy isn’t it? You’d think that something which takes a little strain off the NHS is a good thing. The trouble I think is mostly with not having a big enough pot of money available for insurance payouts if something goes wrong. Funnily enough, when I was forced to practice without insurance before the NMC made having it mandatory, in some ways it made me a safer midwife because I was much more aware of the potential outcomes if things did go wrong. Obviously I would have preferred to have had insurance but back then it just wasn’t available x

  10. I didn’t even know it was possible to have ‘independent’ midwives!! Thanks for sharing & raising the issue which is an important one #twinklytuesday

    1. I think it’s something a lot of women aren’t aware of as a potential option unless they’ve either had a traumatic experience or are not being supported in their choices and then start looking “outside the box”. It’s a shame it’s a choice that is being taken away. Thank you for commenting x

    1. Thank you Lisa – it does help relieve pressure on the NHS in a small way and being able to have that choice is so important. Thank you so much for signing and hosting x

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