Independent midwives at hospital births - any comments?

[acnebride]

I'm potentially interested in booking an independent midwife if i ever get pregnant again (early planning - OK I really want to get pregnant...) The one I would like to go with tells me that if I chose to give birth in hosp, or transferred to hosp, she could only be a birthing attendant, and a hosp midwife would have to actually make the clinical decisions.

This seems daft. I'm about to write suggesting that my local hosp consider a new approach, whereby the independents can be approved to have 'birthing privileges' at the hosp, would have a 'liaison midwife' at the hosp team to consult with, would have protocols covering any points/problems of which they had to inform the liaison midwife, but would otherwise remain in charge of the case.

anybody got any comments before i write to suggest this?

Can't imagine it will happen but if you don't ask you don't get!

ok, this is a really cynical lawyer question, but who would be liable if anything went wrong (God forbid)?

The NHS trust is not likely to want a situation where someone not employed by them (either directly or thru an agency) is making clinical decisions in their hospitals.

it is to do with insurance. independent midwives are not covered by the hospital's liability insurance and therefore are not allowed to deliver babies there. i do not think it is anything to do with operating procedures at the hospital per se.

It's often an insurance and liability issue.
Most trust accept independent MWs as birth partners only. Some don't allow some in at all when there have been problems with one particular ind. MW (happened where I live).

Some independent midwives have honorary contracts with hospitals and by all means write to the trust if they are not offering this in your area. After all, it's not like they are unqualified people - they are registered midwives, bound by the same code of conduct as the midwives who work in the hospital.

I went to the AIMS/ARM conference in october where a man from the unit which deals with risk in the NHS (can't remember the name of it) got a very hard time about this sort of thing. He handled it very well and invited them to talk to him officially to see what problems could be ironed out.

It would prob be worth your while contacting AIMS, the Association of Radical Midwives or the Independent Midwvies' Association to get info about hospitals and trusts which already have these contracts in place as ammunition.

You might also find it useful to ask on the UKMidwifery yahoogroup for examples.

Good luck!

I used an independent midwife with both my babies. Both were born by CS (not my wish, but stuff happens). In hospital, my midwife was technically there only as my helper, but as you're allowed two helpers, that was fine. Because she knew the hospital and all the staff (had worked there as bank), she got into the theatre for both sections, which was very much worthwhile, if against a whole lot of rules.

I think the practical answer is to find a midwife who knows your chosen hospital, or go to the hospital your midwife knows.

As everyone else says, the insurance issue is a big one.

Thanks very much for all your comments which are v helpful. I may look at the honorary contract route as the midwife in question has only just stopped practising at the relevant hospital. There may be an issue though as I know she hated working there - maybe she'd rather not have one!