Has anyone used private or independant midwives?

[Jaimy]

Hi,

I am pregnant for the first time and have heard horror stories about midwives on the NHS, and the shortage of them.

I was wondering whether anyone has used private or independant midwives and is it worth paying for this service? I am due to give birth at Queen Charlottes.

Thanks!

Jaimie

Agree with everything Loopymumsy has said.

I've hired an IM this time around. We haven't had to pay the money out all at once (in fact I'm now 37+1 and have only paid the deposit!). Most IMs will offer a payment plan type thing where you can spread the cost over a year or even two (doesn't cost any extra). We've done this and it's being paid out of my maternity allowance.

I am planning a homebirth and I'm not sure it would be worthwhile using an IM if you're planning a hospital birth as they tend not to be able to do any medical stuff there as they aren't covered on the NHS insurance. If you're planning a hospital birth it might be worthwhile looking into getting a Doula instead.

I have to say that for me it has been worth every penny whatever happens at the birth. I have felt supported throughout my pregnancy. I have had extra visits when needed (at no extra cost - it's an all inclusive price). They arranged a birth debrief for me at the hospital I had dd in and came with me. They got me in to see the obstetric physio in 4 days (doctor had said a 3 month waiting list for physio). On top of that the number of antenatal visits I get is more than I'd get on the NHS.

I also know I'm at risk of pnd again and the number of postnatal visits is amazing - every day in week 1, every other day in week 2, 2-3 times in week 3, couple of times in week 4...though they will come out more if needed.

I used one for about 2 hours and it was the worst decision I ever made.

You can't beat the NHS and if anything went off plan you would end up in hospital anyway.

If you feel the need to spend the £2500+ it would cost, get yourself a spring cleaned house and some help for afterwards.

At QC I would just push like mad (forgive the pun) to give birth in the midwife led birth centre. If you have an uncomplicated pregnancy that is a good place to be. I had my DD on the CL side there and did not have a great time (there was a lot of intervention for no reason that I could see), but from what I hear the MLU is much better.

This time I'm not going to QC (we've moved) and am having a private midwife for a hospital birth. They can't deliver you in hospital but for me it is money well spent because I am having a VBAC and will be labouring at home as long as I can, so I want someone medically qualified with me to be my safety net (as there are additional risks). A doula would, I feel, not be sufficiently qualified for that. But in your shoes, I doubt I would bother forking out for an IM unless I wanted a home birth. And even then I would first check out the hospital homebirth team - they can be very good.

FabBakerGirlIsBack - please can you elaborate on why you feel it was such a bad decision for you?

We used IMs for DD once the NHS became unsupportive, my CMW destroyed my confidence in her to assist at a HB and then DD was resolutely breech. For us, IMs beat the NHS hands down as they allowed us to access the experience to make a vaginal breech birth a safe option - something that's now rare to find within the NHS. We didn't book till 36 weeks, but still got 2 extremely experienced MWs that gave us a lot of confidence in them and the whole thing became a much MUCH more positive and enjoyable experience. By the time DD was born we were welcoming two friends into our house as they'd managed to squeeze in so many ante-natal visits. Care after the birth was also superb and far in excess of that provided to any of my friends by the NHS.

When I found out I was pregnant with DC2 we called one of our previous IMs before we got near the GP. Just knowing that if I have a problem I can call someone that I know, who will take me seriously and spend the time needed to make sure everything is OK (both physically and mentally) is a huge comfort. My CMW was good as CMWs go (especially until we started talking HB), but she was horibly overworked and appointments always felt rushed.

I do think that as it is a much more personal relationship it is important to make sure that you get on with the IM you're considering using and that you have a similar view on birth (or at least that the IM you choose is supportive of your choice).

Re. payment, lots of IMs will also be prepared to barter - one of ours was desperate for a builder, for example.

My experience was that using IMs was the best decision we ever made

I was a bad decision because she turned my baby without my permission or knowledge, I was left in severe pain for the next two days and with my history it was dangerous and should never have been done anywhere but a hospital theatre. I told my NHS midwife and she was furious and the midwife was called in to explain herself.

Also, I was 31 weeks gone and while I understood I would have to pay the full fee, for those 9 weeks she would be unavailable for 5 of them.

I used an IM with my second and third, despite being quite skint.

It was the best decision I could have made and I'll always be grateful to her for the care she gave me. She was outstanding.

I couldn't have got the same type of care on the NHS.

The practice I used was this one - if you're in London or the SE, they come highly recommended!

tinaperridge

Used an IM for my recent DD2 after horrific NHS experience first time round. Still had to transfer to hospital, and was again subject to hospital cock ups - so the IMs can't necessarily stop what the docs at the hospital do when time is of the essence and they dont consult BUT the IM did stop the idiot NHS doctor pulling my womb out afterwards . That alone was worth the £3500.

But the antenatal and postnatal care was also absolutely fantastic (antenatal to prepare mentally for birth and deal with previous birth issues, and postnatal to deal with birth aftermath, hospital acquired infections etc), and also so so worth the money, in different ways. In fact, DD2 is 6 weeks today, and I still have one appointment left with my IM, whereas friends have had 2 postnatal visits from the NHS and thats it.

We have foregone holidays for a couple of years to justify the cost. As with any birth, you don't know how its going to go, and you could be fine on the NHS, but if you can afford an IM I would definitely go for it - at least you know who you are going to get then rather than leaving it to chance. Of course, do your homework, get references and make sure your IM is experienced and sensible - not all will be excellent as the poster above mentions.

Cannot speak highly enough of our IM she was incredible and having built a relationship with her it was such a relief to see her walk through the door and instantly calmed me down in labour.

IMs are often (especially the older ones) very experienced ex NHS midwives who have left the NHS as they no longer feel able to provide the sort of woman centred, evidence based care they were trained in.

Tangle's example of vaginal breech delivery is one example where NICE guidelines based on a flawed piece of research have lead to c-section as 'hospital policy' for breech.

Vaginal delivery of a breech baby in hospital is now dangerous because no one is experienced in it. See Mary Cronk (possibly the most famous IM for more on this)

One to one midwifery care has such amazing outcomes and the only way to access this on the NHS is via the one on one service at QC the Albany Midwives (NHS Caseload midwives but you have to live in catchment which is Peckham I think)

Just a quick one to say that the one-to-one service run my the albany midwives that Susie mentions is out of Kings, not QC unfortunately!

I remember reading this
www.timesonline.co.uk/tol/life_and_style/health/article6482091.ece

the other day and although it is looking at independent midwives in a home birth setting, it would give me pause for thought. Add this to the fact they don't have indemnity...

HateHoovering - I couldn't make your link work, but I think this is the article you were talking about: "Women who give birth at home with an independent midwife are nearly three times more likely to have a stillbirth than those who give birth in hospital, a study has found."

It goes on to say that:
"The groups were matched for age, socio-economic status and other factors such as previous obstetric complications. Nearly nine out of ten women in the IMA group, said they wanted to give birth at home, and two thirds did so. But the researchers noted that women who chose a birth with an IMA member were more likely to have had pre-existing conditions, such as blood pressure or diabetes, or previous obstetric complications.

The risk of stillbirth or neonatal death (within 28 days of birth) was 1.7 per cent in the IMA group compared with 0.6 per cent in those giving birth in the NHS. Once high-risk women were excluded from both groups, the difference ? 0.5 per cent versus 0.3 per cent ? was not statistically significant."

To me this means that the increased risk of still birth or neonatal death was not because women were using IMs - the increased risk was because women who choose to use IMs are often higher risk to start with and using IMs is the only way they can be supported in the birth of their choice. For me, one of the strengths of IMs is that they will take on higher risk women (usually after a detailed discussion of the risks and possible implications) and so give them a realistic chance at a "normal" birth by making them feel supported. 1.7% is higher than 0.3%, but it is still a low number - and I can imagine plenty of scenarios where a woman may well be prepared to take the increased risk for guaranteed 1 to 1 support from a known MW, or for a MW with guaranteed skills not widely found within the NHS.

At the end of the day no birth is risk free and the risks for each birth option will be different for each pregnancy - indemnity insurance is just another risk to factor in to your consideration.

FabBakerGirl - now you remind me I remember your story. It horrified me when I first heard it and it horrifies me now. I'm sorry you had such a bad experience with this particular IM

My IMs deal with loads of high risk cases at home. In fact I'd say that the majority of their caseload have some sort of risk factor that would make a homebirth on the NHS a struggle to organise.

It was the reason why I used them - I had gestational diabetes and a history of large babies. When I'd asked the NHS community midwife about a homebirth she told me that they 'wouldn't touch me with a bargepole' (nice )

I had the same independent midwife deliver all four of my babies at home. (Actually she came arrived five minutes after DS3 but there you go.)

I wouldn't have it any other way.

I had a lovely IM for the birth of ds2 at home and booked with the same one for ds3. Imo it is definitely worth the money. I fully trusted the professional judgement of my midwives and I knew they would not hesitate to take me to hospital should the situation warrant it. Therefore I trusted them enough not to worry about the professional indemnity situation. Also the birth is only one part of the picture. For me, the main contrast between my experience with ds1 (NHS) and ds2 (IM) was the post-natal care. I'm sure I've explored this on mumsnet before if you have the time to search the archives.

I know I was very lucky to have the money to spend on this and I really wish the NHS situation improves one day so more pg women can truly experience 'continuity in care'.

So sorry to hear FabBakersGirl's story and it sounds like she was incredibly unlucky with this particular midwife.