to think that outlawing Independent Midwifery will have far reaching consequences for women's birth choices?

(131 Posts)
TaggieCampbellBlack Sun 03-Mar-13 16:10:16

C&Pd from the Choose your Midwife, Choose your Birth. MNHQ - If you think is is the wrong place for this could you perhaps move it?

Come join us in protest. An end to legal independent midwifery practise is an end to freedom and choice for women. Don't accept this loss. We are planning a demonstation in London on Monday 25th March at 11am

As of October 2013 it will become illegal for independent midwives to practise without insurance. This leaves Independent midwives unable to practise legally. It also has implications for employed midwives in regards to autonomy and registration. Woman will be unable to access the one to one,gold standard services independent midiwves provide unless the midwife is willing to break the law. The Government say it the new law will improve safety. Insurance does not make midwifery safe, good standards do. There will always be women who do not want to use the NHS and therefore may give birth unassisted or use a midwife who will be unregulated through a governing body. This is what will compromise safety. Midwives want insurance to cover their practice but it is not available to them world-wide. Insurance companies are commercial businesses and want to make a profit. They can-not do so with less than 200 midwives currently seeking insurance in the UK and a typical claim reaching into millions of pounds. This is not about practice it is about finance. Please show your support for a woman’s right to choose how they birth where they birth and with whom.

piprabbit Sun 03-Mar-13 19:13:02

You can sue an IM, but I believe that many take steps to ensure that they have minimal assets in their name. Who would want to risk their family's home for the sake of their job (no matter how passionate they are about it).

RedToothBrush Sun 03-Mar-13 19:17:50

I've said the following on another thread tonight about a slightly different subject.

I'm of the firm belief that women do not endanger the life of themselves of their baby willingly or deliberately. If women do something that goes against all advice or evidence, then they do so for a bloody good reason; you need to get to the bottom of those reasons and you need to make sure that woman is supported as much as possible to minimise her risk as much as humanly possible.

If a woman does, she generally will have some sort of belief or ideology at the heart of it; most generally I'd say there's probably a previous trauma of some description at the bottom of it.

Which makes her a vulnerable woman who needs help not judgement or controlling.

So when you are talking about a woman who considers using a IM without insurance, then ask the question 'WHY?' Why would someone take what others would deem, such a risk?

The answer involves a very strong need to avoid the alternative. And if women are prepared to use an IM who they know is uninsured now, then simply banning IMs from practising if they do not have insurance leaves women who are seeking to avoid something high and dry.

This has the potential in some cases where a woman is desperate to avoid a hospital birth, to now try and attempt to give birth either illegally with a willing IM or to try and give birth unattended.

It has parallels with banning abortion. What are the real consequences and just how far will a woman who is desperate go?

thebody Sun 03-Mar-13 19:18:01

Tolliver I do get your point.

TaggieCampbellBlack Sun 03-Mar-13 19:20:04

Well said RedToothbrush.

<<wish I could write eloquently>>

Arithmeticulous Sun 03-Mar-13 19:25:13

To me, the care that IMs give- woman centred, one woman one midwife, long AN appointments at time/location convenient to the woman, experience in more unusual births (breech, twin VB), 6 weeks of PN care - it's expensive if you compare the single cost of birth in an NHS hospital. But if you calculate the cost to the woman work/child care wise, the additional cost of instrumental/CS birth, treating PND/AND etc etc - is it that much more?

I think they are providing the care that the NHS should be.

HolidayArmadillo Sun 03-Mar-13 19:25:35

Very well said Red Toothbrush, I'm not an IM, although I am a midwife, I fear that this ruling coming into force will see a lot more unattended births as women who wish to avoid hospitals and the NHS in general go to extreme lengths to do so. I love the NHS, I love the service we provide, however, I do recognise that it isn't for everyone and IMO we need to have another option, because of the way the NHS is run we have a 'one size fits all' approach to maternity care, and anyone who falls outside the realms of normality has a 'fight' on their hands to get anything other than the prescribed NHS care, which may be wholly unsuitable for her needs. This woman needs another option, she may choose not to use it but to remove that option is very dangerous.

MrsHoarder Sun 03-Mar-13 19:27:09

Redtooth iswym but the other way to look at it is that women are approaching a medical practitioner who they are putting their faith in and will trust because if how they present themselves and because it is easy to trust real individuals they can see. They should feel that these individuals have the same protection a they would expect from their doctors, dentists, layers, a accountants and are protected if things go wrong. Even if this is explained people will think that it can't happen to them (why we need compulsory car insurance).

You can't have it both ways, these are either vulnerable people who need protection or they are capable adults who will find other medical care.

A friend of mine hired an IM for her labour. After a perfectly straightforward pregnancy she was being pressured to accept induction of labour despite daily monitoring showing a healthy baby and placenta. She had planned for a home water birth and didn't see the need to change that. She had a lovely home birth with her IM rather than an IOL which she feared.

The choice should not be taken away from women as to how and where they have their babies. As a student MW I find it very concerning that the culture around birth is becoming more and more medicalised. I fear that a hospital birth may soon be the only option available sad

TaggieCampbellBlack Sun 03-Mar-13 19:34:21

It boils down to choice. Informed choice. I believe that women have the right to choose the birth they want and to choose who they want to care for them through it.
Currently in the NHS you don't have much choice. If you are lucky you'll be allocated a midwife you like who will give you choices within whatever policies exist in that trust. These might be completely different to those in the trust next door.

There is good care within the NHS. But you shouldn't be 'lucky' to get it.

Do you want to be in control of your birth? Or do you want your birth to be controlled by others?

Also what are the chances that after this the government will make freebirthing illegal? Possibly with women being investigated by social services for opting out of the only birth option available, NHS hospital birth.

RedToothBrush Sun 03-Mar-13 19:37:55

You can't have it both ways, these are either vulnerable people who need protection or they are capable adults who will find other medical care.

You can. You can help these IM get the insurance they need, so they can get the care that they feel is appropriate to them, to protect these women. In the end, we will end up footing the bill one way or another; either through the NHS or the benefits/care system dealing with the fail out. Or even the cost of a lengthy court case at the European Court of Human Rights by someone challenging what the UK government is proposing. We don't get out of it, just by banning something! The reality is never exactly what the authorities want, because they don't account for or understand emotions and desperation.

You also need to look very hard at the reasons why women don't feel they can get this on the NHS, and why the NHS is failing them and change that from the ground upwards.

The two go hand in hand, whilst there is a lack of trust in NHS services.

The NHS are IMO unlikely to employ IMs to run practices. Look at the Albany practice, as close to an IM practice within the NHS and they closed it down despite fantastic experience and outcomes for mothers in their care.

RedToothBrush Sun 03-Mar-13 19:40:18

MsIngaFewmarbles Sun 03-Mar-13 19:34:40
Also what are the chances that after this the government will make freebirthing illegal? Possibly with women being investigated by social services for opting out of the only birth option available, NHS hospital birth.

Do you think this would work either? I don't. Many women go into labour and give birth very quickly before they are able to get to a hospital for a lot of different reasons. How do you distinguish between the two, without running the risk of prosecuting perfectly innocent women?

MrsHoarder Sun 03-Mar-13 19:40:38

Is it currently illegal for someone not registered as a midwife to be the only birth attendant (ie for a doula to agree to be present and plan for no midwife)? If so then surely this is just adding one more condition, women already don't have free choice on who they will pay to assist them during birth.

Bogeyface Sun 03-Mar-13 19:42:24

It does seem to be a backdoor way to ban IM, however I agree with PP that MWs shouldnt be practising without insurance.

If insurance is not available to them then surely it would be better to campaign for a good, affordable (state run if necessary) insurance scheme?

As someone with a child who suffered brain damage at birth, I would not want to have babies born with no hope of proper redress if something goes wrong as a result of negligence on the part of the MW, independent or otherwise.

Bogeyface Sun 03-Mar-13 19:44:02

It is already illegal to plan a birth with no medical assistance, but its very hard to prove that someone has done that. It is not illegal to give birth alone if circumstances mean that they can't access care in time, so anyone suspected of doing this could claim that they didnt know they were in labour until it was too late.

somewherewest Sun 03-Mar-13 19:44:46

I'd rather the government focussed, as softly says, on schemes that provide continuity of care for women, such as One to One Midwives in Wirral. Every woman deserves this option, not just those who can afford to go private.

Absolutely. IMs are just not an option for the vast majority of women.

ChairmanWow Sun 03-Mar-13 19:46:57

Two points - a PP responsed that established labours of 24 hours or more were rare (or words to that effect) on the last page. I would challenge that, firstly with my own experience of established labour in hospital of 24 hours including 3 hours of pushing. I wouldn't have wanted an exhausted MW to deal with such a difficult end stage. I also have 2 close friends who had longer established labours ending in EMCS due to foetal distress. Again, exhausted MW plus distressed baby is not a good mix. Of course it's anecdotal but I would think we all know people who have had long, established labours. .

Secondly this cannot be compared to abortion because banning abortion leaves no alternatives for women wishing to terminate pregnancies. Stopping IMs from practicing without insurance still leaves women with the choice of hospital, MLU or home births attended by regulated and insured NHS midwives.

I'm sorry for anyone losing their livelihood or their choice of an IM but I really do think it's scary that anyone engaging in an activity which carries such devastating risks can do so uninsured.

Redtoothbrush a lot of things implemented by governments don't work and mean people are persecuted unfairly sad

I have only been on a community placement for 5 weeks and know of 2 babies born before a MW could attend or the woman could get to the hospital. It happens fairly frequently.

RedToothBrush Sun 03-Mar-13 19:51:07

Stopping IMs from practicing without insurance still leaves women with the choice of hospital, MLU or home births attended by regulated and insured NHS midwives.

I'm sure there are women out there that don't consider this a choice though. This is the problem. The choice is NHS or not NHS in minds of a few.

But it doesn't Chairman. Many women are excluded from a MLU or a home birth because they don't fit into the policies and guidelines of the particular NHS trust they live in, see my earlier post for an example. The NHS is very risk averse, understandably so, but if a well informed woman no longer has the option of an IM then they are forced into a hospital birth.

Bogeyface Sun 03-Mar-13 19:55:04

Private hospital births are a choice too, for those who have money, and only those with money can afford IM.

I never cease to be amazed that despite having the best free healthcare system in the world, even with all its failings, we are not happy. Try living in America and then see how you feel about NHS births!

TaggieCampbellBlack Sun 03-Mar-13 19:58:34

The 'choice' between hospital, MLU or home, within the NHS is only a choice if you fit in with their criteria.

5th baby? Hospital.

Previous caesarean? (even if you have had VB since) - Hospital.

Short staffing? - No home birth

Raised BMI? -Hospital

Breech? -Caesarean

Older than 35? -Induction at 38 weeks

'Overdue'? - More thsn 40 weeks? 40+10 in some places, 40+14 in others? - Induction. Or your baby will die.

That's 'choice' within the NHS.

MrsHoarder Sun 03-Mar-13 19:58:47

X-post it isn't the government's responsibility to provide insurance for private businesses over whom they have no say in the running. The rcm could help the ims negotiate with the insurance companies and i'm sure they will be able to find a price. Given the level of risk involved this may be high, they will then have to decide whether to put prices up or close.

I expect the government to ensure that all businesses facing individuals have suitable insurance in case of damage to those individuals. Especially businesses wise target market is vulnerable people.

I would also expect a private abortion clinic to be required to have the same level of insurance if that kills that straw man.

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