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Saving choice for pregnant women

(49 Posts)
lizzybeltane Tue 04-Feb-14 16:42:51

I believe in a future where women know and trust their midwife, have unhurried appointments, at their own convenience, in the privacy of their own home. A midwife who is on call and available to attend her in labour. Not only does this model improve women's experience it also has effects on the outcome of labour. Increasing the rates of vaginal birth, reducing the length of labour, the need for interventions and pain relief ( al 2012).

Every year thousands of women make this choice and vote with their feet, paying for care from a midwife they know and trust, yet this choice is about to be permanently removed. There are over 200 midwives working this way currently. Some in fledgling organisations but the majority are self employed. In the UK this year Midwives will become one of the very few professions that can no longer be self-employed. This is not because of safety or regulation; this is because of a European directive that has brought a change in the law. We need the government to support Independent Midwives, and this is within their power, but they need to hear from women that this is a choice that they want to remain.

I would very much like Mums net to take up the campaign to protect choice in the UK for pregnant women by taking up the campaign to support independent midwifery.

SoonToBeSix Tue 04-Feb-14 16:45:29

I already have this on the nhs with one to one midwives.

plutarch14 Tue 04-Feb-14 16:51:19

I might be misunderstanding, but can you explain how the government can ignore an EU directive? I believe they have direct effect, and governments can't just 'opt out', although they have discretion about how they implement the objective.

Apologies if this is explained in the link - can't click on it as on iPad and it's not a clicky link.


organiccarrotcake Tue 04-Feb-14 16:58:08

This is such a desperately needed option. While companies like One to One (and others) are in some places, many others are not being commissioned by the NHS and there is not this option. They are still NHS affiliated though, and therefore not acceptable to some women who may have seen the worst of trauma through the NHS.

I absolutely support this campaign 100%. Without Independent Midwives we would lose so much of the desperately needed skills that the NHS seems determined to drive down, such as supporting breech birth or multiples born vaginally.

lizzybeltane Tue 04-Feb-14 16:59:02

How the law is implemented is down to individual governments. There is a plan on the table that they can assist with if they choose to do so.

plutarch14 Tue 04-Feb-14 16:59:58

Also - can someone tell me what the insurance position is with independent midwives? I would have thought the premiums would be crippling.

plutarch14 Tue 04-Feb-14 17:04:01

Ah - I have found this link which explains:

The directive states that independent midwives must have professional insurance - not a bad idea as this is what is paid out if something goes wrong and can be millions of pounds as it often pays for lifetime care for an injured child.

It is suggested that the govt contributes £10m to a central fund for this purpose. Sounds sensible to me - if the govt refuse to fo this, someone from Dept of Health needs to explain why.

lizzybeltane Tue 04-Feb-14 17:06:52

we need to raise awareness so that the government can see this is an issue that people care about.

plutarch14 Tue 04-Feb-14 17:12:04

I'm not sure the government are that interested in what people care about - they certainly don't seem to care about being unpopular.

However, they care a lot about saving money. The plan makes financial sense so perhaps that is what we should focus on if we want them to take any notice. Perhaps another tactic for IM UK (as well as raising awareness as they are already doing) would be to put together a financial statement showing that the plan would actually save the government money and publicise that.

Pooks123 Tue 04-Feb-14 18:39:35

Neighbourhood Midwives was set up for just this reason, it is 100% employee owned, social enterprise with full insurance. OK, it's not self employment but pretty good all the same.

Tubbs01 Tue 04-Feb-14 18:51:04

We had our son 5 months ago at home due to the terrible treatment we had to endure from the nhs previously. If independent midwives and doulas didn't exist I think we would have probably free birthed. There was no way going back into the nhs was even a remote possibility.

MinesAPintOfTea Tue 04-Feb-14 18:57:44

I am self-employed.. To work in my area I have to have appropriate insurance which is not funded by the government. The government ensures a standard of midwifery for everyone, if people want to opt out of that system they should pay the full costs, including appropriate insurance.

Why can't the nmc organise this as a group?

mumofkandj Tue 04-Feb-14 19:05:41

Independent midwives offer a higher standard of care. They accept women that the nhs deem high risk support and information to make informed decisions. They make the time to know their clients.
As for insurance, what feels a better motivator- midwife who's premiums might go up or a midwife who loses her house if she screw up? Insurance doesn't make a safer practitioner, it just provides premiums and a business for insurance companies ( which, as they won't get enough profit means they aren't attractive to a profit making company).
The insurance is the insistence of EU law- IMs have worked for years in this country without an issue. Sadly nhs healthcare options are driven by insurance, the costs for the nhs being sued are huge.
My plan was to know the midwife when in labour ,but the antenatal care and postnatal care was so different to what I expected- I hadnt anticipated knowing my midwife would make such a wonderful difference.

MakesAMessWhenStressed Tue 04-Feb-14 19:54:25

I had wonderful NHS ante-natal care in my first pregnancy, unfortunately it was wonderful right up to the point they suspected I might become a risky birth (I didn't) and they refused to have me in the local Maternity Unit. As soon as that happened I experienced the worst of the NHS - a cascade of intervention, four different midwives, more and more invasive procedures with no clear explanations or choice and post-natal care that left me with crippling depression, PTSD, difficulty breastfeeding and trouble bonding with my baby for nearly a year.

I fully intend to go with an independent midwife when I am next expecting. Thanks to my previous experience I suspect I will need more one to one care than last time, the NHS will offer me less. I want to be assured that a midwife I know and trust, who knows me, will be with me when labour occurs, because I don't trust NHS staff after my last experience. Please please please let me have that choice to make.

Women who have had a good experience with the NHS may not understand how essential indie MW care is, but even thinking that my only option may be to go through the NHS again makes me panic and feel very anxious.

Mumsnet - can you put your considerable weight behind this matter? I turned to you after my terrifying experience for support. Help protect me and others like me. Please

wessexindependentmidwifeErika Tue 04-Feb-14 20:23:43

It is imperative this choice stays. All of my clients are women who cant have their needs met in the NHS. Many have traumatic experiences from previous births they wish to avoid, many have received sub standard care, are frightened. If independent midwifery is lost, women will have no safe alternative to go to. If we are lost, the nhs system will be stretched even further. Immediately it will cost £13 million to accomodate all our clients! This doesn't take into account the additional cost that comes with our caseload being (70%) high risk, and therefore more likely to receive intervention in the nhs. Interesting, not with an independent midwife. Despite the majority of clients having risk factors our caesarean and instrumental rates are half that of the NHS!

independent midwives also support the nhs when they are short staffed. I have attended women in labour when there were no midwives available. We have supported midwives when they have needed extra skills.

and what about the midwife shortage? If the government support the insurance solution IMUK have found, 5000 midwives who are already registered and qualified could work self employed. Our survey said 90% would! This would relieve NHS midwives greatly. It would be better fir them and for the women accessing the NHS as their midwife wont be as stretched. Thousands if midwives leave through burnout. This is a way not to lose them. 30% of students each year will never get s job in the nhs as there are no vacancies! This wastes £10 million of tax payers money every year in training!

please support the choose your midwife campaign.

MinesAPintOfTea Tue 04-Feb-14 20:52:41

I don't think demanding the government funds the insurance for your private businesses is fair though. Even if you indirectly benefit the nhs, every other self-employed person or small business has to pay their own insurance premiums.

Yes the nhs needs to employ more midwives under better working conditions but the government is trying to provide midwives through direct employment, not providing financial support for private healthcare actually maybe that's what they are doing to dismantle the nhs Private healthcare should be able to find itself including adequate insurance for when things go wrong.

10 million across 5000 is only 2000 a head if there's genuinely that many midwives wanting to practise independently. That's not loads more than I pay as a computer type.

plutarch14 Tue 04-Feb-14 22:51:32

It's not about the government funding a private business Mines (although they effectively do this every time they cut tax for small businesses). It's the fact that the choice is £10m to enable independent midwifery to continue or £13m at least (according to a PP's figures) if all the women who would have had independent mws come to the NHS. It's actually saving the government money AND providing better/more diverse care.

wessexindependentmidwifeErika Wed 05-Feb-14 01:17:06

To clarify the insurance is funded through premiums paid for by the midwives. This is a substantial sum. The financial support we are asking for is in the unlikely event of a large claim the govt will honor a claim which the company cant fund. The risk assessment shows in the last ten years we may have accessed a couple of hundred thousand pounds of this govt grant or guarantee. This is in comparison to £3.2 billion spent in compensation in the nhs over the last 10 years. This is because the one to one care we give results in less opportunity for negligence and less reasons for complaint.

the govt can give a guarantee which means they don't even have to hand the money over! It will def save them money and get more midwives working and improve maternity options. They have done this for insurance companies involved in housing and other areas already so a precident is set.

if IMs could buy insurance they would. The fact is insurance companies can make more money on other projects so there are no policies available to buy. So, midwives are setting up their own company (which is usual in these circumstances) and asking for govt over the initial years. This is a public health issue and the department of health have a responsibility to do what they can i believe.

Madasaspoon Wed 05-Feb-14 11:22:15

Independent midwives are SUCH an important option. I "couldn't afford" an IM if I had any more children. I'd probably have one anyway. It is SO IMPORTANT to be able to trust your care provider, and to have the option of continuity of care. The effect on the labour and birth itself is huge.

I do worry that standard of care will slip if the gold standard is no longer there to aspire to. I know in some areas it's not that fantastic anyway.... can it afford to slip further?

Why I chose an independent midwife...

My independent midwife took over my care at 36 weeks, conducting all of my antenatal check-ups, going personally on-call so she would be guaranteed to attend my birth, and visited us many times up until 28 days afterwards to support me in my journey to motherhood and ensure that all was well.

This service was not available on the NHS in west Cornwall. Due to staffing issues, homebirth provision is not guaranteed, and most homebirthers haven't met the attending midwives. In fact, when mentioning the value of caseloading midwifery and continuity of care at a maternity stakeholder event, I was informed by our local community midwifery manager that women apparently "don't care" about being attended by a familiar midwife during birth!

I wanted to choose who would attend me. I had been trained as a student midwife in London that caseloading was the gold standard... and I wanted it for myself! I didn't want a stranger to be there, entering my home at my most private moments. Instead I wanted to invite a chosen and trusted person I'd built up a relationship with, who knew me and what I wanted. Instead of rushed 10 minute antenatal appointments with an NHS midwife in a GP surgery, my check-ups with Evony were in my own home and at least an hour long each, during which time we planned, laughed, drank tea and looked forward to the birth together.

You can read my birth story here if you wish:

AtYourCervix Thu 06-Feb-14 12:21:02

For me this is about choice and equality and a woman's right to choosing what sort of maternity care she wants. The one to one service is fabulous but only available in a few areas (same as neighbourhood midwives).
Just yesterday I read (in the daily fail, sorry) about a hospital trust that is not 'allowing' homebirths any more.
Women's choices are getting taken away and it is massively important that independent midwifery continues to give the gold standard care they provide.

Also choice for midwives to practice how they want to, safely.

Please support the campign MN.

CarefullyAirbrushedPotato Thu 06-Feb-14 12:44:37

Surely all women should be able to choose their birth support?
I can't understand why we can't have similar to the NZ model where I could choose to spend my allocated funds on a hospital, birth centre or midwife care at home.

Everyone should be able to have continuous care from a known practitioner and we shouldn't have to crimp and save and borrow to do it.

It's cheaper and safer, what else could possibly be an issue?

capercaillie Thu 06-Feb-14 16:40:13

It is an important choice to have. I opted for an independent midwife for my first child - because the NHS didn't have a midwife/ midwife team available for me between 25 and 37 weeks for antenatal care due to restructuring. I would have had to seen my unsympathetic doctor for routine appointments and wouldn't have had anyone to discuss birth plans with etc. I also realised that it was important to me to have met the midwives who would be with me in labour beforehand so that I felt comfortable with them in my own home. By the time I got round to having my second child, I realised I wanted the care of the same midwives again - who knew how my first labour had progressed and my pregnancy/postnatal history. Their postnatal support was excellent and I credit them with a smooth start to breastfeeding for both children.

missismac Thu 06-Feb-14 18:05:18

It's crucial that as women we stand up for ourselves and our choices, and to my mind this touches the very heart of who we are.

To have some faceless EU bureaucrat, or money-minded uk politician deciding to remove the choice from you, you best friend/ daughter/ daughter-in-law/sister/special woman in your life for no better reason than money, is outrageous and something we should fight against every step of the way, with every fibre of our being.

Those of you saying that 'independent businesses fund their own insurance so why should this be any different?' don't have a clear picture. As I understand it the largest negligence payouts from the NHS by millions are Obstetric negligence claims. Most (all?) UK Insurance companies are unwilling to take on this level risk by insuring IM's so finding a company willing to insure has been, until this year impossible (never mind that the % of IM's who have been sued for damages is teeny-tiny in comparison to % of NHS Trusts). Now there are one or two considering it, though as I understand it nothing concrete yet. Of those insurance companies who are considering it, the annual premium that they have mentioned as being worth their risk is hugely more than the annual salary any midwife could ever hope to earn, independent or not (remember this is not a business, like a cafe or something that can expand indefinitely. In the end it's limited by how many women one Midwife can safely look after in any given year). So if Independent Midwifery is to continue and be legal under EU law it needs help. Our Government needs to act, it must ensure that AFFORDABLE, and appropriate insurance is available to IM's. This is important.

This IS important. Most women will give birth at some point in their lives, and yes - we are blessed with a non-fee paying at point of service NHS, but for a small but significant (and growing) few this is not the service they want. They want a midwife they've had a chance to build a relationship with, one they know and trust, they need to give birth the way they chose - not the way an institution dictates because of protocol. The need to make decisions based on what is best for them, and their particular circumstances, not what's best for the 'average woman in this situation' (NICE, CNST, Trust protocols etc etc). So for that sake of these women, for the sake of the women you love who might be one of those women in the future, please fight to maintain this choice. Even if it's not your currently your choice, even if you think it never will be.

Independent Midwives do something special. They do it quietly and with dignity. This something special is available to you and those you love. Please don't let this choice slip through our fingers just because an unthinking political quango somewhere has made a decision. You only have to cast your eyes across the pond at the terrible birth situation in the US and Brazil to see where allowing choice to erode leads us. 90% Caeserean rates in some Brazilian cities - a whole generation of women who have never met anyone their whole lives who have given birth vaginally. Really? Do we really think that only 10% of women can give birth vaginally. Anyway -that's another thread. Sorry to digress. So this is about more than just a small bunch of self employed Midwives working for women who can afford to pay for them (another commonly presented myth), it's about another erosion of the rights for women. The right to chose how they birth their own babies, what happens to their bodies and who will be with them to help them through the stormy seas of the perinatal period. This is something that should be decided by YOU, not by insurance, or by politicians but by you - Women who can give birth, and the women who love them.


wessexindependentmidwifeErika Thu 06-Feb-14 19:23:17

CarefullyAirbrushed Potatoe - totally agree and this is a model of care we have suggested to Dan Poulter Health Minister. The NHS is paid slightly more for each woman than an independent midwife would charge as well!

benbusby Thu 06-Feb-14 21:23:48

As father of two choosing the type of birth we had was very important. We had a torrid experience with the NHS for our first child, where we had to fight for a home birth; leaving my Wife in no fit state to birth naturally. I feel this had further repercussions with my wife's post natal depression. It took us three years to regroup and feel ready for another child, mainly because I was afraid of watching my wife go through the same ordeal. However thankfully we had the amazing fortune of meeting an independent Midwife. Under her care she made us feel empowered and in control. Consequently we experienced an amazing home birth.
I believe without the choice women will continue to endure births that are not owned by them, but are of the convenience to the nhs. Women need to feel in control and relaxed to birth.
Saving independent Midwifes is the only way to retain this choice for women and couples.

SuseB Fri 07-Feb-14 10:18:26

I don't have personal experience of independent midwives, but I did have three home births and am outspoken about how amazing they were and how important I think it is to have genuine choices in childbirth. I would love to see the power of Mumsnet support this campaign.

SidandAndyssextoy Fri 07-Feb-14 10:27:50

I had that gold standard care of case loading NHS midwives that so few women can access. They supported me through two pregnancies with medical issues, gave me strength to question hospital protocol, spent as long with me as I wanted in my own home talking about my worries and getting to know me (and my partner), and celebrated with me as I had two births as I wanted them. I was unbelievably lucky. If this care cannot be rolled out across the NHS (and it would save money if it were) then the next best option is to ensure that independent midwives can still practice. Hopefully Neighbourhood Midwives will soon be commissioned like One to One and deliver care within the NHS.

Sm1ley Fri 07-Feb-14 10:44:32

It is all about choice and who we trust to make decisions on our behalf. The hospital midwives answer to the trust who set procedures and protoc

Andcake Fri 07-Feb-14 10:51:23

Shame on you mumsnet for supporting this campaign. I don't like this govt but I don't think helping independent mw out with insurance is a good use of tax payers money. Improving Nhs care yes not subsidising the wealthy who want something different

Sm1ley Fri 07-Feb-14 11:00:36

Trusts set protocols to be one size fits all. They cannot take account of individual wishes.
As to paying, I've heard many stories of women in need being supported regardless and a charity is being set up to widen access based on need.
IMs do so much more than catch babies. They provide real choice for new families.
As to NHS funded companies like one to one, they will be subject to the same (similar) protocols. You will only be 'allowed' them if deemed low risk (if not currently then just wait until budgets start to bite.

moongroove Fri 07-Feb-14 11:08:53

Choice for women and for the midwives. Simple.

mrsmacaroni Fri 07-Feb-14 12:29:50

Independent midwives are not just for the wealthy, I've known women who really can't afford it choose turn to IMs when they are let down by very badly by the healthcare service. In fact where I live women have remortgaged their houses or got loans from family. Some women irrespective of their financial means choose to prioritise the care they want during pregnancy and birth because it's important to them and their family. The care you receive far exceeds anything I have seen in the NHS and has an impact on long term emotional and physical well being.

Yes, I think the DOH should invest more in maternity services, we all do, but the investment in IMs is small change for them and keeps choice alive for women everywhere.

ixqic Fri 07-Feb-14 15:45:14

No woman ought to choose to birth alone due to the bad behaviour of midwives. Until the NHS can consistently provide a sterling service to every woman who wants a supported home birth then there will be a need for Indy midwives. The government needs to protect the choice for all women not just try to force everyone to a service which is letting down many. Here is someone's description of going alone after poor NHS care

EatsCakeForNoReasonWhatsoever Fri 07-Feb-14 15:46:49

AndCake - shame you didn't read the thread before posting, one of the posters above has explained very clearly that the government would only be backing up the IMs, not funding them.

Not to mention the fact that Mumsnet isn't supporting the campaign, we're just hoping they will. Honestly. What a half-baked post.

And IMs are not 'for the wealthy'. They're for terrified women who are willing to pay extra for the support they need. And some of the IMs I know offer discounts for the impecunious, or payment plans, or skill swaps (if relevant). This isn't some nebulous luxury item, you know. This is desperately needed healthcare that the NHS can't be bothered to fund, as far as I can see. Women's healthcare just isn't a priority.

MinesAPintOfTea Fri 07-Feb-14 16:09:32

EatsCake we've been told that independent midwives are cheaper than NHS ones. Maybe if you charged a bit more you could afford to insure yourselves and not rely on the government.

And agreeing to underwrite is a big ask. Especially as the campaign doesn't make it remotely clear that that is what they want or what measures will be put in place to make sure that only responsible midwives operating in a reasonable manner are covered. Even that petition only calls for the health minister to look after you, without saying what is actually wanted.

Yes currently independent midwives are rarely sued but that is because:
a. you have to be pretty determined and confident to practise uninsured when a small case could take you out financially.
b. few solicitors will take on a case against an uninsured private practitioner because its not worth it: they wouldn't have reasonable payout for the damages involved.

b is of course why the EU has demanded that midwives be insured for the protection of pregnant women and their babies. Out of interest, are there any EU countries with independent midwives and are they insured?

joyfull Fri 07-Feb-14 19:45:15

I'd seriously consider using an IM if I were to get pregnant again ;) I've had great treatment in NHS with both a home and a hospital birth. Things were a bit more complex with the last birth and I think IMs have retained more skills outside of blanket, one size for all, lawsuit prevention rules. I'd at least like there to be a conversation and a choice... Anyway, I thought the government were pro privatisation?!

Sammyniccy Sat 08-Feb-14 09:54:34

Come on mumsnet support this cause......fundamentally , its a human rights issue. X

BanSidhe Sat 08-Feb-14 12:26:21

on your point b)
The EU regulation was actually developed to have an avenue of compensation for those individuals who choose "health tourism". If your boob job in the Baltics develops a complication which can be proven to be result of negligence, then you have the the means for redress.
I would also like to say that having insurance does not "protect" against anything. Having good quality continuity and consistency of care is far more protective of the health of the mothers and babies.
As has for your point about charging more: that would take IM care way beyond the ability of some families to afford the IM care.
Several IMs provide pro bono care dependent in need and some even take payment in kind.

Onesleeptillwembley Sat 08-Feb-14 12:41:36

Please don't support this, MN. Subsidising private enterprise is just not on. And frankly, what percentage of women can afford a private midwife? This isn't about 'women's right of choice' this is about subsidising a privileged few.
I do agree the choice should be there, but not subsidised by the people that can't afford to access it.

Paintyfingers Sat 08-Feb-14 14:15:31

I think independent mw should remain an option.

Arohaitis Sat 08-Feb-14 14:35:14

Well I guess if they do this for private organisations then they will have a hard time defending why they don't do it for all health care staff and then who else will want the gov to pay their insurance? and since they have very little direct control over who they are insuring to practice independently they perhaps don't see this as a useful line to take.

Just wondering

I'm not familiar with what someone earlier was talking about (the gov bailing private companies out) but it is presumably linked to the 'too big to fail' thing and I guess only time will tell whether that was the right decision)

EatsCakeForNoReasonWhatsoever Sat 08-Feb-14 18:33:47

MinesAPint - just to clarify, I'm not an Independent Midwife, or anything similar. Just someone who believes in what they do and who has put off having a second baby for quite a while to ensure we can afford an IM when the time comes.

wessexindependentmidwifeErika Sat 08-Feb-14 22:50:48

This is def not asking tax payers to fund a private business. Midwives will pay premiums which will cover the majority of all claims if they come in. The insurance needs underwriting for large claims (which are not expected due to the risk assessment) over the first years as the company establishes. This is a public health issue. The consequences of losing this choice will have detrimental affects on women, their rights and choices, their future and their health. IMs are the only maternity system currently meeting their own targets.

Midwifeangela Sun 09-Feb-14 18:02:51

I am an IM; I care for many woman who have been traumatised by birth and need the care from a known midwife to support them. The DH's own report commissioned by them says that IM's should remain an option. This is not about 'private care' or not have insurance; this is about choice outside of the NHS and its policy driven culture, and about enabling IM's to put into the place the insurance as requested so that we can continue to provide the care women seek.

Pollymummy Tue 11-Feb-14 20:23:36

MN please support independent midwifery. It is so important women have this option.
I had an independent midwife for the birth of my second child. This was after a traumatic experience with my first. (Thankfully he was fine, but I was left in a real mess). When it came to even thinking about having a second child I was terrified of going through the same thing again.
Being able to build up my trust in the person who would be attending to me was critical to me feeling safe. It meant so much to me that she understood completely my history, fears and hopes for my second child's birth. My second child's birth was hard (aren't they all?!). But, with her support during, and importantly before, the labour I did it. Emotionally I was in a completely different place (a much happier place) then after my son's birth. This not only benefited me but my children too.
The level of support I received from my midwife just was not available on the NHS. While I wish it was, it isn't, and we need to ensure having an indep midwife is an option.

I don't think indep midwives are just for the rich. They also set the gold standard of care (which good maternity services in the NHS are modelled on). Finally, it's about choice. Women should be able to choose who provides their care. We should be supporting and aiming to extend this choice to all women, not letting it slip through our fingers.

BabyWitch Fri 07-Mar-14 16:39:09

Please support this campaign, MN. This is about CHOICE. For women to have genuine CHOICE in how they birth, and for midwives to have genuine choice in how they work.

I have had one baby on the NHS, and never again. I hope to have another baby, but only with an IM. The thought that this choice is being taken away from women, both personally and professionally, is outrageous in this day and age.

Even though I had a poor birth experience on the NHS with my baby's birth, initially I was not fully behind supporting IMs. I inaccurately thought they were only for pampered women who could afford to throw money at something they've already paid for through their taxes.
I was wrong. All types of women can benefit from independent midwifery care - and it is the vulnerable women and those who do not fit into the ever-shrinking 'low risk' box who need access to this choice the most.
My choices were eroded, ignored and belittled under NHS care. I was coerced and forced into unnecessary intervention that only served to hinder my recovery. Breastfeeding support and advice consisted of continuous bullying. I was never once treated like an individual.
If we lose IMs we all lose. IMs hold the knowledge and experience in dealing with special types of birth, such as vaginal breech. If IMs are allowed to go out of business, this font of knowledge and expertise will die with them.
I could never be pregnant again, fearing not 'the worst', but that something might come up, such as the baby's odd position, where I would be forced into having a c-section simply because I was being dealt with by medical staff who had no experience or confidence in the 'wait and see' approach.
IMs were asking the government for a One Off payment of £10m to help to set up their insurance kitty. This is less than their equivilent productivity would cost the NHS - and they are also relieving the NHS of these women. (However, the trusts do not support IMs because they are effectively losing clients).
IMs are worth their weight in gold. To us, and to future generations.

mum1976 Mon 10-Mar-14 22:25:17

IMs are not just for the rich - we used hard earned savings to pay for an IM with baby no. 2 because the NHS would not support our choices.

First time around we suffered through fighting for a home birth, being bullied to tears by consultants, having midwives who were total strangers at the birth, multiple changes of midwives through labour, not being allowed to be in a position of my choosing, and finally the cascade of intervention which made me feel totally powerless and ended in a c-section, which i still believe may not have been necessary if they hadn't been bound by arbitrary NHS protocol (time-limits in my case).

In contrast, our IM really did provide the gold-standard of care - she spent time to get to know us and what we wanted, provided information to help us make informed choices, supported those choices, was with us for the whole labour and ultimately helped me birth a 10lb 3oz baby at home. It was a wonderful, healing, empowering experience. The NHS wouldn't have "allowed" me to do this because my 3 hour 2nd stage would have breached protocol. I probably would have ended up with another c-section.

I'm not trying to criticise the NHS, they mostly do a great and very necessary job. However, their one-size-fits-all policies did not work for me and it would be a sad day for women if our choices regarding our own births were to be removed. Losing IMs would mean exactly that for women like me. As I understand it, midwives will be the only branch of medical practitioners who are unable to work independently as they are the only ones for whom commercial insurance simply isn't available. They are not asking for special treatment, not asking for the government to pay for or subsidise their insurance premiums, just to make insurance available for them to buy so they have the same opportunity and right to work independently as anyone else. The government should be helping find a solution...the only midwives who even meet the governments own standards of midwifery care are IMs!

WaitingAndSpinning Tue 11-Mar-14 12:17:14

This is about women's rights. Their choice of where to birth, how to birth, and who they want with them during and after pregnancy and labour.

It's not just about homebirth either. I had an amazing independent midwife for second birth after a terrible prior experience. Sadly I couldn't give birth at home as I'd planned but she was there to support me all the way from early pregnancy to during and after my eventual C-section.

With NHS care I felt like my pregnancy and birth were one long fight. Constant interference and bullying about how and where I should give birth and pushing for constant unneeded interventions. Choices that were mine were presented to me as something I had to do with no understanding or explanations of risks. The thought that I would not be able to choose my own midwifery care in future pregnancies terrifies me.

For women that have been traumatised by past NHS birth experiences they may feel that their only choice is then to birth unsupported.

It can only benefit all women, that those who choose to, can access independent care. It relieves the burden on the NHS allowing better care from them for the women that do choose it.

In addition to all of this, independent midwives keep alive skills and knowledge that are being lost in the NHS, for example regarding natural breech births.

If this goes ahead, not only are we saying women in the UK may not choose who cares for them during labour and birth, we are also saying that midwifery as a profession may only exist via the NHS. Given that most midwives are women, yet another choice removed. It shocks me that in 2014 we would countenance less choices in pregnancy and birth care than in many other years before.

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