I’m an independent midwife -AMA

[Sussexmidwife]

Have you ever wondered what private midwives do? AMA!

If someone hires you, are you then guaranteed to attend their labour? How do you manage your own life around this, so you have to drop everything to attend?

How does it work with regards to the other midwives at the hospital? Do you have to follow that hospital's guidelines or cab you do your own thing, and does the hospital still assign a midwife to the woman?

Do people who hire their own midwife have bigger demands or higher expectations?

What do you do if the woman is having a super long labour, how do you get your rest?

Are you mainly supporting women who want home births and more than a Doula?

Why did you decide to go private?

How much do you charge?
What different about being a private midwife?
Do they have more appointments with you?
Do you go the hospital with them if they choose or have to have a hospital birth?

More questions than I thought

I've had two births with an IM. One woman, one midwifen with hour long antenatal appointments, a lot of laughs and cups of tea. It was bloody brilliant.

Could you go back to the NHS now?

How much do you charge? And do you regularly see patients with birth anxiety?

Oh, lots of questions!
Suninthesky we try to have no more than three women due at a similar time, but for any birth we are on-call day & night from 37weeks until baby arrives. Most of us tend to have a buddy midwife who is willing to help if two calls come at once. If that looked possible we would let the women know & introduce the other midwife, just in case. Amazingly it is rarely a problem.
It is a particular type of lifestyle, but the emotional rewards are huge. I couldn’t have done it when my children were small, but they are now all adults.
If we attend a woman in hospital, insurance issues in most cases mean that we cannot be clinically responsible for care, so we become your supporter/advocate/advisor and an NHS midwife will be there too. Guidelines are just that, guidance - so we can discuss things and then you decide. No-one HAS to follow guidelines, you can say no but it does take confidence to do so.
I think expectations are different if you have a private midwife in most cases, but our clients are a pretty broad cross section of the population!
Super long labours are managed by using our buddies. I am good at sleeping in short burst in unusual places.

@cannotmakemymindup
Private midwives vary in what they offer and specialise in. I don’t do many home births because I specialise in complex situations, either where there are concerns about the baby’s health and development or pregnancies after loss. Because of that the majority of my clients prefer to birth in hospital , some have c/sections, so I work with the team to prepare the best situation for mum & baby and then support throughout. Doulas are great if you want nurturing support and the presence of someone who respects and supports natural birth. Midwives offer a rather different service, we have the same qualifications and skills as general NHS midwives but most of us have specialist skills. help women weigh up options for care by providing evidence and experience both of when things go well and naturally as well as when things get complicated.

@OlivejuiceU2
I had worked for the NHS since 1980 and gradually found that the demands were getting higher and higher with less and less resources. I felt I was no longer able to give women the care I believed they should have.
Having held several specialist midwifery posts and being passionate about what I do, I decided that working independently was for me. It certainly isn’t an easy option though!

@PixieDustt For one off or occasional consultations I base my charges on £50 an hour. I sometimes wonder if I should increase that because I know colleagues who charge a great deal more, but I want to try to keep it accessible and about the same as you might pay a physio or counsellor. I’d be interested in anyone’s thoughts on that.....
For packages of care, spending on circumstances it can range from about £1,500 to £10,000 depending what people want/need. Again in many cases I offer services more cheaply than some because I believe in the woman staying involved with the NHS and so getting scans, blood tests etc done that way. If you are entitled to NHS services, why not use them? You can still have the benefits of continuity of care with me.
I think the difference with a private midwife is that it is genuinely about what is best and most suitable for you. I do a lot of visits in evenings and at weekends because that is most convenient for people who are working. We talk about how often you want to be seen, do you want to go to an antenatal group for classes or do you want me to work through that information and preparation with you. If women are seeing a specialist I can accompany them to act as advocate if required, I take calls from them whenever they have a question so they don’t have to search for information (unless they want to!) and so on. Yes I do support during hospital birth and other hospital admissions.

@TwoHeadedYellowBelliedHoleDig
You sound like my kind of woman! Yes, that is a lovely way to work and we become very close to our clients, and their families, pets etc!
I still do occasional shifts in the NHS to stay in touch and sometimes when they need specialist duties covered, but I wouldn’t want to be back in the NHS full time now. I salute all those who are continuing to do so. It is mega tough.

how are you different to a doula id your clients are accessing the NHS and you don't do anything clinical

@yellowpolkadots101
See my reply above about charges. I also do some work where I charge very, very little in cases where there are serious issues affecting the baby and the family need specialist support but can not afford to pay normal rates. This is usually where there is such a serious issue that they have been offered termination of pregnancy but for moral or religious reasons that is not acceptable, so they continue their pregnancy is the knowledge that they will have to say a final goodbye to their baby at or very soon after birth. This is known a perinatal hospice care and is the single area of care I am most passionate about providing. Very few hospitals have a specialist midwife with knowledge and experience working such situations.
Yes, I do see quite a lot of women with birth anxiety, whether primary or secondary to difficult experiences in previous pregnancies.

I'd love to have a private midwife if I had a spare 10k+ sounds brilliant.
Although wouldn't fault my NHS midwife but she was had to get hold of which is understandable

@PixieDustt if you are having a straightforward pregnancy a package would be nowhere near £10k! That only becomes relevant in really complex cases with lots of extra appointments, time in hospital and many hours of counselling followed by several days of care during baby’s very short life when continuity is massively helpful.

Sounds like such an interesting job, thanks for the insights

I have one more question...

In a recent episode of '999 whats your emergency' on channel 4 they did a episode about unintended home births. The advice to the person helping the mother was to get clean towels and a safety pin in case the baby delivered before the ambulance crew got there - I can see why you'd want towels but what's the safety pin for? I was baffled!

@SunInTheSkyYouKnowHowIFeel I share your bafflement (is that a word?!)

The only thing I can think of is to use as a makeshift clamp in case the cord snapped during/after delivery and you had nothing else?

I tried to find a private midwife when my unborn baby was diagnosed with a life limiting condition for support as you suggest and they turned me down because it was too complex. Turned me off independent midwives to be honest. So with my next two I just had shit births.

So who are you, where are you based and how can I find a midwife who offers what you offer? (Just in case I do decide to have another which isn’t terribly likely)

@TheDIsiilusionedAnarchist I am so very sad to hear that, but it is a very specialist area. I will PM you.

What's going through your head when you're staring at a woman's fanjo? Do you ever judge on how tidy they keep their bush?

@roses2 I'm thinking about whatever the reason is that I am there! Perhaps watching as baby slowly emerges (that is incredible!) or perhaps to check for or repair any tears etc.
Absolutely no judgement from me. It's hers, so she can do what she likes with it! I am always aware that many women find it highly embarrassing, so try to be discrete and always ask for permission before looking or doing anything