Q: What is an Independent Midwife

Independent Midwives are fully qualified midwives who have chosen to work outside the NHS in a self employed capacity. Independent midwives fully support the principals of the NHS and are currently working to ensure that all women can access ‘gold standard’ of care in the future ( LINK). The role of the midwife encompasses the care of women and babies during pregnancy, birth and the early weeks of motherhood. Traditionally one midwife would look after a woman throughout her pregnancy, giving them a chance to get to know one another. Having established a trusting relationship the same midwife would attend the birth and care for them both afterwards. Research has shown that many women still want this type of midwifery care and that it best helps women to cope with the challenges of labour and the transition to parenthood. This is the care that an independent midwife provides. Many independent midwives will also undertake extra training so that they can offer extra services to their clients such as complimentary services .

Q: Are you qualified midwives and how are you regulated?

Midwifery is the most securely regulated profession in the UK. All practising midwives must adhere to the Midwives' Rules which are enshrined in the 1902 Midwives Act of Parliament and subsequent amendments. All independent midwives have undertaken full midwifery training and are subject to annual supervisory visits and equipment checks. In line with the requirements of our regulatory body, the Nursing and Midwifery Council, we are required to ensure that our clinical practice is up to date and that our actions are within our sphere of competence.

Q: What would happen if there was an emergency?

There are very few genuine emergencies during childbirth; this is why research has shown that for most women homebirth is at least as safe if not safer than hospital birth. As the experts in childbirth, midwives are trained to recognise any early warning signs that things may not be progressing normally and to take appropriate action. If the unexpected should happen, all midwives are trained in emergency resuscitation of both mothers and babies. Independent midwives attend regular training to maintain and update their knowledge in neonatal resuscitation and obstetric emergencies. Independent Midwives carry all the necessary emergency drugs and equipment and these are checked on a yearly basis by a supervisor of midwives.

Q: What emergency equipment do you carry?

Independent Midwives carry all the necessary emergency equipment to ensure that if a baby is born needing resusitation, this can be performed. For example: oxygen, suction, bag and mask. All midwives are trained in emergency resuscitation. Independent Midwives also carry emergency drugs in case a woman is bleeding heavily. We update ourselves on a yearly basis in emergency neonatal resuscitation and many of us have attended emergency skills workshops tailored for independent midwives attending homebirths.

It is a requirement that our equipment is checked on a yearly basis by a supervisor of midwives. As Independent Midwives, often working alone and mainly facilitating homebirth, we are very conscious that we need to be completely up to date with all the necessary skills should an emergency occur.

Q: If I get transferred to hospital will you still be able to look after me?

Independent Midwives are able to stay with you in hospital in case of transfer. A few Independent Midwives have honorary contracts with their local hospital and will provide your midwifery care. However, most Independent Midwives feel that they are better able to be your advocate by staying with you as your birth supporter and allowing a hospital-employed midwife to provide your clinical care. If a caesarean section is needed, most hospitals will allow your independent midwife into theatre with you and your partner.

Q: If I dont achieve my birth plan do I still have to pay?

Yes. You have booked an Independent Midwife for midwifery care and she will continue to provide it. She will do her best to help you achieve the birth of your choice but some things are out of her control. Sometimes it may become necessary during your pregnancy or labour for your care to be transferred to hospital or an obstetric team. Your midwife will have acted properly and within her midwifery rules by detecting a problem and referring appropriately with your consent. Whatever the circumstances your midwife will already have incurred expenses, worked many hours with you, supported you, been on call for you and therefore she still has to be paid.

Q: I have been told I can't have a homebirth by my consultant but still want one, will you take me on?

Independent Midwives support womens' choices, they do not ‘tell’ them what they can and cannot do. We share information with women and provide professional guidance so that they can make their own decisions about what they feel is best for them and their baby. If you make a fully informed choice then in most circumstances we will support you. Many Independent Midwives will take on the care of women who are deemed "high risk" and have been refused home births or natural births by the NHS. For example women who have had previous caesareans, women with pre-existing medical conditions or women carrying twins. Your Independent Midwife will discuss all your options with you.

Q: As I am booking so late do I have to pay the full amount?

Yes. Your Independent Midwife will often have to work harder within a short space of time when a woman books late. There is much behind the scenes work in the life of an Independent Midwife!

Q: Independent Midwives don't have insurance, what implications does this have for me and my baby?

It is a sad fact of life that some babies are born damaged and most of the time it is nobody’s fault and therefore there will be no compensation paid no matter who was providing the care. The implications of Independent Midwives not having indemnity insurance is that in cases where a baby is born damaged, and it is proved to be due to the midwife’s negligence, there would be no financial recompense via an insurance company. If negligence was proved any pay out to you and your baby would depend on the independent midwife’s assets and therefore is unlikely to be large.

Independent Midwives UK continues to pursue Professional Indemnity Insurance on the commercial market as their members would prefer to be insured given the choice. In the UK the number of Independent Midwives is currently quite small (less than 150) and therefore insurance companies will not make a profit by selling them professional indemnity insurance. The lack of being able to purchase insurance has no connection to how or where Independent Midwives Practice.

Q: There are a number of Independent Midwives in my area, how do I know which one is right for me?

It is usually best to have a consultation with an Independent Midwife prior to booking her. Independent Midwives realise how important the relationship is between a woman and her midwife and they will not be offended if you choose to meet several midwives before making your choice. It is important to make the right choice; think about the qualities of the midwives you have met and who you will feel most comfortable working with.

Q: How much do Independent Midwives charge?

As Independent Midwives are all self-employed they are all able to choose what they charge. Independent Midwives have to cover all their own costs such as training, equipment and travel. Rates may vary in different areas of the UK; currently a complete package of care will cost you between £2000 and £4500 (approx). Most Iindependent Midwives will want to receive payment in full by the time you are 36 weeks pregnant but if you have genuine difficulties in paying please discuss it with your Independent Midwife as most can offer flexible payment plans.

Q: Can I still receive NHS care if I book with an Independent Midwife?

Yes. The Department of Health has made it clear that women who choose to have their midwifery care provided by an Independent Midwife are not opting out of the NHS. You are fully entitled to all the blood tests and scans that a woman under full NHS care can have. Should you require any specialist input or emergency care the NHS will provide it. Independent Midwives have the same referral rights as NHS midwives and are able to arrange a consultant appointment or hospital admission if required.