IMs offer solution to midwife shortage and ward closures

• Independent midwives reduce NHS caseloads, support the NHS, and save the NHS £10 million a year

• IMUK estimate 4000 midwives could be back to work and save NHS up to £200 million a year.

• Independent Midwives UK urge government for support to find workable affordable insurance.

Trusts are closing their maternity wards due to staff shortages and women are forced to travel miles to other hospitals. Some mothers are denied midwives to attend their homebirths due to staff shortages.  18% of trusts are carrying a midwife to mother ratio higher than recommended.  At this difficult time, Independent midwives UK have raised the issue of how they can support the NHS system with the Department of Health.  With a 22% increase in the national birth rate and a deficit of 5000 midwives (RCM), the NHS has never needed more support.  Dan Poulter, Health Minister has announced 5000 more midwives in training, however, The Higher Education Statistics Agency statistics show that 20% of midwifery graduates will not secure a job and of the 80% who do secure employment, only 50% will be able to work full time (RCM 2011).   

Midwives are working in a system which is constantly under strain and where retaining midwives is problematic (AIMS and RCM).  The NMC informed IMUK that 4,178 midwives on the register did not notify their intention to practice this year, yet a recent IMUK survey of approx. 900 midwives and student midwives showed that over 90% would access insurance if it was available, and work in a self- employed model.

Increasing the number of independent midwives would result in better maternity care for every woman.  “I have been called by women in established labour, to attend them because they have been denied a midwife due to staff shortages.  This is frightening for women and not conducive to a supporting normal labour and birth.  We know if women are frightened, especially when they are denied a midwife, that labour may not progress easily and complications could arise.” says Erika Thompson, Independent Midwife.  Independent Midwives UK are keen to discuss with the department of health how they may support their local trusts. 
Independent Midwives are fully qualified and regulated and yet they are under threat of being made illegal in October of this year when an EU law comes into effect, requiring all health care professionals to have insurance.  Although Independent Midwives want insurance, there is currently not a commercially available policy on the market.  Independent Midwives are not proven as carrying any extra risk, but insurance companies have found it difficult to differentiate between midwifery care and obstetric care, which is at risk of large compensation settlements.

“It seems ludicrous that we have thousands of midwives registered but not working.  If we can secure an insurance policy with the support of the government, we believe many midwives could offer an alternative solution.  We can even discuss commissioning care to the independent midwife when caseloads in the local trust become high.  This will not only benefit the women, but also the trust and the midwives working.’ Says, Jacqui Tomkins – Chair of Independent Midwives UK.

Independent Midwives UK are currently campaigning to find workable affordable insurance before October. ‘We are urging the government to work with IMUK to help us break down the barriers facing us in the commercial insurance market’ says Jacqui Tomkins.
Background / Notes for Editors:
 Independent Midwives:
• Registered and regulated by the Nursing and Midwifery Council with yearly supervisory meetings & study requirements.
• Self-employed. 
• Provide continuity of care during pregnancy, birth and post-natal.  Often assist women who have previously had poor experiences of care.
• Retain valuable skills that are disappearing in mainstream maternity care, such as vaginal birth of breech babies and twins. 
• Meet government targets set in policy document ‘Maternity Matters’, which currently the NHS system does not.

The Finley Scott review commissioned by the Government to advice on this subject states:
 "In respect of independent midwifery, the review recommended that for groups for whom the market does not provide affordable insurance or indemnity, the four health departments should consider whether it is necessary to enable the continued availability of the services provided by those groups; and, if so, the health departments should seek to facilitate a solution (recommendation 20)."