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

[TaggieCampbellBlack]

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.

Taggie

No one can force anyone into hospital, and they have to provide a MW for a homebirth by law. I had my 6th at home, despite a determined consultant trying to talk me out of it with dire warnings of me bleeding to death on my lounge floor.

MrsCB I luffs you. It's so nice to hear a qualified MW speak out as opposed to just going along with the status quo. Our lecturers are fired with enthusiasm but practicing MWs just seem to have run out of fight :(

I agree that there are not many units, but they do exist. I am just pointing out that the argument that it is NHS hospital or nothing is not true. As I said, I had my 6th at home with an NHS team and it was fantastic!

They can if there are no midwives availabe for homebirths. It happens frequently when staffing levels are low. Then the 'choice' for women is to do it on their own or go to hosptal.

Yes but as I said earlier its about getting what you want without a fight. Because that fight is designed to exhaust you and wear you down and put you back in your box. Only the very strong will fight against the might of the NHS 'pathway of care', I'm all for informed choice, I'm all for consultants explaining why they wouldn't recommend a particular course of action and in many cases it is completely reasonable, in other cases it is just a case of 'the rules' being blindly applied without examining the woman as a whole.

If that woman has the option of discussing things through with an IM, an IM who knows her stuff and has experience in providing care to women who don't fit the tricky boxes the NHS prescribe this can only be a good thing?

Actually, I have known of cases where IM's have been sent out instead of NHS midwives when staffing levels don't allow...

Some people are just anti homebirth under any circumstances. There is a huge lobby of doctors who feel that homebirth should be completely illegal like some parts of the states.

It is an interesting question who takes liablity when someone does choose to have a homebirth against all medical advice. Should a high risk mother who was advised against a homebirth for twins in a footling breech position really be awarded compensation by the NHS when it all goes hideously wrong because she insisted on her "right" to a homebirth?

How do we allow women to take responsiblity for their bodies and the consequences of their decisions when things go wrong?

I think that patients of independent midwives having to pay for insurance depending on their circumstances would be the best way to allow independent midwifery to continue.

Exactly. With my last pg I had borderline diabetes, mostly controlled by diet. Growth scan at 37 weeks estimated a 4.5kg baby. I was planning a home birth. Was told by 3 different consultants that I was endangering mine and my baby's life. I tried to argue that I had a 4.48kg baby previously with no issues during delivery but this didn't change their view.

I gave up fighting and had IOL at 39 weeks. Bearing in mind how fiercely I fought and I was relatively well informed it doesn't look good for Jane Bloggs who wants a choice in birth. Women should have options and not have to fight.

The RCM used to offer insurance but stopped a whie back.
As far as I know there is no company offering insurance at any cost for independent midwifery.

Really sometimes things just happen and no court would award damages in that case if there was no medical negligence. If the woman chose a homebirth and the MW screwed up then it would be different. But someone doing something that they know is risky and despite the best work of the MW, a baby died or was brain damaged then there would be no case for the MW to answer.

With the NMC 'supporting' her it will always be the midwife's fault. cynical and 2 glasses of wine down

dentists doctor s etc all have to have insurance the insurance for an obs/gyn doctor is nearly 3 times that of a general surgeon almost 10k a year but then the defence union will pick up tab if necessary, I do not think anyone should be practising without insurance

while I was on a maternity break by insurance with dental insurance company was put on hold, ie still officially a member but could not practice but still covered if anyone complained about what i did in my last job, it also covered for good samaritian acts but I could not do dentistry without restarting the insurance which I did do when I restarted work a few weeks ago

I am just surprised it was not illegal to practise without insurance already

signing a disclaimer when there is no alternative may well not be legally binding anyway

I am not against choice but I am pro making it illegal to practice without insurance,if there is a demand insurance will become available

same as having to have your car insured but if you are so big a risk no-one will insure you that is not the governments problem it just means you can't legally drive or have car on the road

l'm surprised that you think it acceptable for anyone practicing midwifery to be uninsured. Anything that keeps charlatans out of medical practice has to be a good thing.YABU

You seem to be confusing professional qualifications and insurance to provide financial compensation in the event that something goes wrong.

There is no insurance.

Independent midwives are not 'charlatans'.

because a hospital has insurance does not mean that they are best.

Midwifery is not 'medical practice'.

I want choice. I want all women to have choice. I want my daughters and their daughters to have choice.

Independent midwives are trained and registered professionals.

I'm quite shocked that anyone working as a midwife would do so without insurance. Making it a legal requirement is a good thing imho.

If it stops independent midwives, then I guess that is bad news for them and for those who would choose that route.

I presume, although may well be wrong, that insurance companies take a risk based approach to working out first if they can or will provide insurance and second the cost of that insurance. I guess they look at the risks entailed in the work, how likely they are to happen, and then work out a cost for the insurance. They want to make money and therefore need to provide insurance, but the amount they charge for insurance needs to cover the cost of overall claims against them plus provide a profit margin. I would assume, perhaps wrongly, that if insurance is very high that it is a reflection of the money they expect to have to pay out.

I didn't mean that post to sound anti independent midwives. Tbo, it really doesn't matter to me personally as I am not having any more children.

I would just question the risk of being involved in childbirth without insurance and why insurance as an independent us so high.

"But someone doing something that they know is risky and despite the best work of the MW, a baby died or was brain damaged then there would be no case for the MW to answer. "

You would think so, but insurance is to cover the costs of fighting an entirely ridicoulous court case. Many people may take the happless midwife to court becuase they have a no win no fee lawyer, even when there is no case to answer for. This regularly happens within the NHS already.

I feel that insurance should pay out when there is a brain damaged baby whosever fault it was. I can't help wondering that if there was no lawyers or court fees whether there would be more money for brain injured children.

Giving birth will always be risky whether you choose a hospital or give birth at home. Even with the best of medical expertise brain damage happens. Prehaps we should all take out insurance to protect us in the event of having a brain damaged child, or even some other special need.

just to be clear I am not against independent midwives or indeed independent anything but I am against anyone in medical or related areas chiropody/ osteopaths/ people doing botox/ private physios etc etc working without professional indemnity insurance. midwifery is a medically related profession

as with any other medical type profession you must not act out of your area of competence and must refer on urgently if necessary if things get beyond your scope, so a midwife could be sued whether in NHS priivate or what for failing to spot trouble and no referring on /calling ambulance/ obstetrician etc and rightly so

I do agree that the ambulance chasing type lawyers may need some curbs but that does not mean that compensation should be limited because the independent can not personally pay out

Redbindy, IM's undergo exactly the same training as NHS midwives. And many of them also practice within the NHS as well.

Really but no one would take out that insurance as it always happens to someone else. Until the day it happened to me or more accurately, my son. Would I have insured against it? No, same as I didnt insure against a multiple birth.

I still think that any medical professional, and a midwife IS a medical professional, should be insured.

It's not about how good they are, how professional, how well trained etc. As saratigh said, all those in medical profession should be insured, if nothing else to provide a safety net should something go wrong. If things go wrong in obs and gynae it can be very expensive.

"as with any other medical type profession you must not act out of your area of competence and must refer on urgently if necessary if things get beyond your scope, so a midwife could be sued whether in NHS priivate or what for failing to spot trouble and no referring on /calling ambulance/ obstetrician etc and rightly so"

A midwife who was incompetent would be disciplined by Nursing and Midwifey Council and risk losing her career. I feel that displinary action by a regelatory body is best way of managing bad practice.

"some curbs but that does not mean that compensation should be limited because the independent can not personally pay out "

At the moment compensation is limited to what an IM has means to pay. Insurance has a maximum limit of what will be paid out. I believe that more money might be available if there was no need to prove blame.

It's not about how good they are, how professional, how well trained etc. As saratigh said, all those in medical profession should be insured, if nothing else to provide a safety net should something go wrong. If things go wrong in obs and gynae it can be very expensive.

I agree, but I was correcting the assumption that IM's were charlatans. As it stands all midwives in the UK have exactly the same standard of training.