The death of independent midwifery?

[Snaf]

May I draw your attention to this?

I am a fervent supporter of the NHS and the struggle of NHS midwives to provide good care and support everyday, but I also feel very strongly that alternatives should be available to those that want/need them. This proposal is yet another nail in the coffin of maternal choice.

If this legislation goes ahead, it will effectively mean the end of independent midwifery. I know that lots of MNers have had great experiences with IMs and I'm sure the IMA would appreciate your support if you (and anyone else!) would like to lend it.

Hi Loopymummy,
they were talking about the report on maternity services that came out this week and had a person from the report and an IM talking as well as a few comments from women who had had bad experiences.

This is such a difficult issue. A huge proportion (over half, I think) of the NHS indemnity bill is down to maternity cases, so the insurance costs are very high. Mears is right to defend the RCM - they would have to raise their membership fees very significantly to provide insurance cover for IMs (even if they could find an insurer willing to take them on, which hasn't been easy). They polled their members on this some years ago and the vote was overwhelmingly NOT to do this.

There are actually very few independent midwives making a full-time living from it - when I worked in the area a few years back it was something like 30 in the whole of the UK. So there are no economies of scale and no weighty combined voice.

It is so important that independent midwifery survives - not just for their clients but because of their creativity, commitment and pioneering spirit that has benefits for all women and midwives. But the truth is that they are a very small band of women whose way of working simply does not fit with the modern healthcare system - and the healthcare system is not flexible or patient-centred, and has very little incentive for taking action on this.

Hi Hester,

I think there are now some 200 IMs working. The last I heard were that the numbers were rising due to midwives being v unhappy working in the NHS.My IM made a v comfortable living and she was the main earner in her house. The NHSCommunity Midwifery Model (see www.onemotheronemidwife.org.uk) is the answer that the government should be taking note of.

You are right about the cases in the NHS but that is for obstetrics. Midwifery is a different bag altogether and a much safer bet for insurance companies. Anyway, in all cases, negligence has to be proven for a penny to be paid out.

Exactly Loopymumsy. With the one to one care with an IM surely there is less chance of something going wrong because of negligence? There are always going to be negligent practitioners but if you have chosen your own midwife, you would have some guage of her competance and could of course sack her if she was not up to scatch?
That is not saying that things don`t go wrong, of course they do but it would be less likely because of someones negligence?
Does that make sense?!

Yes, mum2sons, 200 IM, but only a small proportion working full-time. I think the number who can afford the kind of insurance fees that are likely to be levied is very small indeed. Which means that they - and we - need the health service to see this as a shared problem, which it is not likely to do.

I'm not sure I understand your distinction between obstetrics and midwifery for insurance purposes. though they are classed as obstetrics cases it is not always obstetricians who are accused or actually are at fault - very often, it is midwives. The fact is, these cases are often very expensive because they involve a baby that has been damaged at or just before birth, and the settlement reflects the costs of providing care for the whole of the baby's life. An uninsured independent midwife would have to be successfully sued for just one of these cases and she would be financially ruined - and still unable to provide adequate compensation for the family concerned.

Please don't think I'm being unsympathetic to the problems faced by independent midwives - far from it. I'm just saying it is a fiendishly difficult problem.

I agree Hester, such a difficult one.
Maybe the best thing all round would be for the government to ensure some kind of affordable insurance. However, although most IMS support the NHS community midwifery model, many don`t want to exclude women who want to completely opt out of the NHS. There will always be those women who want to opt out and they need to have the care an IM can provide.
I think at the moment the IMs are stuck between a rock and a hard place. It must be terribly stressful. I really hope that some sort of solution is found

comment.independent.co.uk/commentators/article2390874.ece

Fab article here from Rowan Pelling who links to OMOM and the campaign

comment.independent.co.uk/commentators/article2390874.ece

thanks Loopymumsy, not sure how to do the link thing!

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Hear hear Danae.

It is a feminist issue and one that effects us all. To destroy independent midwifery, destroys another choice and also leaves a gaping hole where women who may have never considered IM care, find themselves needing IM care and it not being there anymore.

IMs dont just do wealthy women. My IM used to do quite a bit for nothing, especially when a woman was left in a nightmare situation.

I agree with Rowan Pellings Independent article this weekend. Even if you never want to have this choice for yourself, at least at the moment you have a choice. Take IMs out, you will never have that option. Youll never know what you missed til it is not there any more

Yes, my IM had her garden landscped by one clients husband. They do a kind of bartering system sometimes.

bump

have a look at this: \link{http://edmi.parliament.uk/EDMi/EDMDetails.aspx?EDMID=33023&SESSION=885}

oops cant do the link thing

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