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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Original poster

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

130 replies

TaggieCampbellBlack · 03/03/2013 16:10

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.

OP posts:
Original poster
TaggieCampbellBlack · 03/03/2013 16:13

Oh. and I haven't anything to do with the organisation. But I believe passionately in womens rights to choose whatever care they want in pregnancy and birth. Government changes mean that choices are being denied.

OP posts:
sleepyhead · 03/03/2013 16:15

To be honest, the choice of an Independent Midwife has always been far out of the reach of most women for financial reasons.

But, I think the change in the law is stupid and won't improve safety in any meaningful way.

CloudsAndTrees · 03/03/2013 16:16

This leaves Independent midwives unable to practise legally

No it doesn't. It means independent midwives need insurance. I'm actually quite shocked that they don't already have to have insurance. Insurance is strongly recommended if you are doing manicures, never mind delivering babies!

gordyslovesheep · 03/03/2013 16:16

lots of women cant access this 'gold standard' due to lack of money

I am confused as to why they can't get insurance

I am not sure if yabu

sleepyhead · 03/03/2013 16:20

I don't think there's any company in the UK at the moment who will insure an Independent Midwife. Birth damage can be claimed for decades after the event and claims can run into the millions - not a good risk for insurers.

So, in effect this law has the result of banning independent midwifery.

AmberLeaf · 03/03/2013 16:21

I think that the insurance is not available to them. As in the insurance companies won't provide it?

I heard about this quite a while ago.

edwinbear · 03/03/2013 16:27

Having had an independent midwife for dc2, after a horrific NHS midwife led birth for dc1, I hadn't realised this was being made law. When I had dc2 my IM and I obviously discussed the insurance issue but this was 15 months ago and I haven't kept up with the discussion. I won't be having a dc3, I am having major corrective surgery on tuesday to fix the damage the NHS caused during dc1's birth, but if I were, I have to say, hell would freeze over before I let an NHS midwife anywhere near me again.

Fleecyslippers · 03/03/2013 16:40

I agree that insurance will not automatically make a midwife 'safer'. I do however believe that there has to be a move towards more regulation of independent midwives in light of the findings of Claire Teagues inquest.

CloudsAndTrees · 03/03/2013 16:45

Ok, I didn't realise that they couldn't get insurance.

How's that going to work then?

cory · 03/03/2013 16:55

So currently what happens if an insured midwife does make a mistake and the baby is born with lifelong disabilities? Who picks up the tab?

If a mistake is made by a hospital midwife, you can sue the hospital and hope to get support paid for by their insurance- who can you sue if there is no insurance?

Remembering that this may make the whole difference to the quality of life to that person for the next 70 year, it is a question worth asking.

Not because there is anything wrong with independent midwives; just that mistakes will inevitably happen sooner or later in any birth situation and then money needs to be found. Of course it doesn't make the midwife safer- but disability comes expensive.

Softlysoftly · 03/03/2013 17:09

While I'm sorry to hear about pps birth injuries I would presume an independent mw would have at one point been an NHS mw for experience/training therefore discounting NHS mws is a little Confused.

I don't think they should be practising uninsured sorry so disagree with the protests.

A better approach would be to increase the availability of NHS mws for continuous community care and home birth if that is the mothers choice.

Softlysoftly · 03/03/2013 17:11

Or encourage independent mws services to become part of a private care organisation so they could get insurance cover as part of the wider business medical cover eg BUPA hospitals

EuroShaggleton · 03/03/2013 17:26

I agree OP. There used to be a wonderful independent birth centre in Tooting. That closed a few years ago because of the insurance issue. Now it seems that women who want a home birth with the continuity that an independent midwife offers will not be able to do that. Women should have the choice.

Softly I think I can safely say that none of them wants to be practising uninsured. If sued, they would be personally liable and could lose all their assets. But they are providing a valuable service.

Currently it is my understanding that you can have a private consultant-led birth at a number of hospitals around the country, but it you want a midwife-led birth, your choices are NHS or the Portland in London (which costs far more than an independent midwife does or the Tooting centre used to).

sleepyhead · 03/03/2013 17:28

Cory, as far as I know (and it's not a choice I'd make for myself so I don't know that "far"), currently the IM makes the woman employing her aware of the insurance situation in advance - whether that's a legal requirement or not I don't know, but all women employing IMs should be aware of it and I'd be amazed if it didn't come up with the most cursory research into a decision that you're paying over a grand for.

So, if the midwife makes a mistake you could presumably sue her for everything that she has, but that would be peanuts compared to a payout from the insurance company. It's a risk you take when employing an IM.

But many women employing IMs have had previous bad birth experiences on the NHS as a result of routine practice and presumably have made a calculated risk that the IM is likely to result in a better outcome for them this time.

The NHS picks up the short and long term medical tab, but that happens when private hospitals make mistakes too.

VivaLeBeaver · 03/03/2013 17:35

The govt need to look at setting up/facilitating an insurance scheme for independent midwives. Not necessarily directly but by helping with talks with insurance companies to sort it out.

As a midwife I'd never be an independent one while I can't get insurance.

And it does worry me that a family could have a devastating consequence due to the actions of an independent midwife and have no compensation. Bringing up a seriously disabled child is not cheap.

TraineeBabyCatcher · 03/03/2013 17:36

I belive you sign a disclaimer to say you will not sue her if anything happens while you or the fetus/infant is in her care.

Bue · 03/03/2013 17:38

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.

RedToothBrush · 03/03/2013 17:39

TaggieCampbellBlack, are you aware of 'Ternovszky vs Hungary'. If you aren't I suggest you find out about it, as I think it might be relevant and might help you with what you are trying to do. Its not exactly the same situation, but I don't think its hugely different.

A film was made about it called Freedom for Birth: The Mother's Revolution.

The Huffingtonpost ran an article about it, and linked to a shorted version of it which is here

RedToothBrush · 03/03/2013 17:41

Basically I think there might be a case that to answer using that ruling that the legal situation is the UK government have a legal obligation to ensure that independent midwives are able to get insurance.

I could be wrong, but I would look very closely at it.

MsIngaFewmarbles · 03/03/2013 17:44

Insurance can be found for IMs. Its difficult but it is there. The problem is that the annual premium is around £ 40k. Most IMs wont earn anything like that figure.

TolliverGroat · 03/03/2013 17:44

That wouldn't be legally enforceable, though, surely, TBC? You can't exclude liability for death or personal injury caused by your negligence.

MsIngaFewmarbles · 03/03/2013 17:46

Is that the film about Agnes Gereb? A mw offering home births who is or was under house arrest for offering women this choice?

ilovesooty · 03/03/2013 17:47

The govt need to look at setting up/facilitating an insurance scheme for independent midwives. Not necessarily directly but by helping with talks with insurance companies to sort it out

I agree. I'd always assumed they had to be insured and am shocked to discover they aren't, but I can see why it's problematic on thinking about it. However, if the government has to contribute financially to make that insurance viable I'm not sure that ought to happen.

toobreathless · 03/03/2013 18:00

I am STRONGLY in favour of insurance for IMs though I agree that there needs to be a way of doing this in a more affordable fashion. It is however not unusual for some Drs working privately to be paying premiums of over £10,000 a year but clearly this needs to be balanced against income.

I also strongly in favour of tighter regulation of the working practices of IMs. While the vast majority are competent professionals practicing in a safe manner and providing an indispensable service (admittedly to those who can avoid to pay them) the few dangerous ones are more dangerous than they would be in other professions die to the lack of adequate regulation.

VivaLeBeaver · 03/03/2013 18:03

Signing a disclaimer isn't enforceable. If negligence is proven then the family could sue the midwife for everything they have. Which would mean the midwife would lose her house, car, savings, etc. but realistically it would mean the family get 200k if they're lucky......one of the most recent compensation payouts I saw for negligence around childbirth was for £12million.

Most independent midwives are fantastic......but I have to agree that been independent doesn't mean better. Though they definitely have more time to spend with you. I know two independent midwives who have never worked in the Nhs, went straight to independent practice on qualifying. Personally I think you need experience to move away from the safety net of having colleagues around you, etc.

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