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, working alongside the NHS and cooperatively with obstetricians, GP's & other healthcare professionals when necessary. Independent midwives attending home births carry full indemnity insurance and are currently working to ensure that all women can access ‘gold standard’ of care in the future, see https://imuk.org.uk/ for more information 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. The Nursing & Midwifery Council main website, http://www.nmc-uk.org/General-public/
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 home birth 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 resuscitation, this can be performed. All midwives are trained in emergency resuscitation for both babies & women. Independent Midwives also carry emergency drugs in case a woman is bleeding heavily. We update ourselves on a yearly basis in emergency adult & neonatal resuscitation and many of us have attended emergency skills workshops tailored for independent midwives attending home births, annually. It is a requirement that our equipment is checked on a yearly basis. As Independent Midwives, often working alone and mainly facilitating home birth, 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 don't 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 home birth by my consultant but still want one, will you take me on? Independent Midwives support women's' 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: 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 £4000 and £5500 (approx). Most Independent 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, extra ultra sound scans or hospital admission if required.