What is an Independent Midwife?
Good question! Most people have never even heard of us, so you’re already ahead. We are fully qualified NHS trained Midwives who have opted to work in a self-employed capacity directly for our clients rather than for the state (NHS) or a private employer. Our reasons are varied, but most IMs want to give clients and their families the kind of care they would want for themselves or their daughters, without the time and resource constraints of the NHS nowadays, and without the policies and restrictions of private health providers.
What’s the difference between Private and Independent Midwives?
Private midwives work for a company, and as such have contracts of employment and policies to adhere to. All midwives are regulated by the NMC to ensure they are safe practitioners, so by working independently IMs are free of additional contractual or local policy-based restrictions so they can fully support their clients’ decision-making without coming into conflict with an employer. IMs are proud of their Independent status, and see it as a means of protecting women’s rights and of preserving clinical practices which are in danger of being ‘guidelined out’ such as vaginal breech birth and twin home births. IMs are able to respond to new research quickly, and as we work across many areas we are aware that guidelines are not universal and that many of them are not founded on robust research. Independent Midwives have been deemed the ‘gold standard’ of Midwifery care.
Why would I pay for something that it free on the NHS?
The short answer is you’re not. The service IMs offer is not the same as that provided by the NHS. We see our clients more often, and each appointment is longer, and we see you for longer after your baby is born. We offer the same routine clinical care that an NHS midwife offers (urinalysis, blood pressure monitoring, abdominal palpation and fetal heart auscultation, or listening in) and then spend upwards of an hour talking through any worries, your various options, your plans and whatever is on your mind.
My questions are open ended (I tend to only ask two: How are you? How is your baby?) as I have time to explore whatever is on your mind at that time with you, whatever that may be. IMs support our NHS colleagues and value their role if you need hospital attention for any reason. However, the time we can spend and the knowledge we have to have to support you in your decision making is just not part of routine NHS care any more. One key marker of this is the number of women who give up breastfeeding before they wanted to through lack of support. IM clients have excellent breastfeeding rates not because we pressure women to do so, but because we have the time and expertise to support women who want to.
Do I have to pay for anything else?
Possibly. If you are entitled to NHS care you can have routine scans and blood tests through them (we would organise this for you and take bloods at home for laboratory analysis). If you are not entitled to NHS care anything undertaken by them could be chargeable. All clients have the option of paying for private scans and blood tests. We can advise on these.
Do Independent Midwives make reckless decisions for their clients?
Absolutely not. Sometimes clients book with an IM because the decisions they are making are being labelled as reckless if they are not following guidelines or local policies. Independent Midwives don’t make decisions for their clients, but support informed decision making by them. Our role is to indicate the options available to you in any given set of circumstances, give you as much information as is relevant and pertinent (including, “nobody knows, there is no robust research” if that’s the case), try to help you understand the pros and cons of the various options (often referred to as risks and benefits, but sometimes they’re not all that risky or don’t have much benefit…) and then support you to make the best decision for you and your family. This may not be what your IM would have done but that’s ok. It’s your body, your baby, your choice.
Are Independent Midwives politically driven?
Oh yes! Well, all the ones I know are. We are fundamentally convinced that women have the legal, moral and inalienable right to choose what happens to their bodies. We are also convinced that when women are given support and as much information as they want and need to make decisions without any form of pressure they make good decisions. If you back anyone into a corner where they feel coerced or restricted they are likely to make decisions in an oppositional (no!) or compliant (oh, ok) basis and neither of these might be right for them. We also believe that people have the right to change their minds and make ‘unusual’ decisions without giving a ‘good reason’ for doing so and that is ok. We also think nobody knows your body and your baby better than you do, or is more invested in either of your wellbeing that you. Human rights stuff. You’d think it was a given. Sadly it just isn’t.
Why do I need an Independent Midwife? I’m under Consultant care.
You may need us more then! Increasingly women are deemed to have ‘risk factors’ which mean their care is consultant rather than midwifery led. These factors can be as simple as being a bit older or a bit fatter right through to some really quite complex health conditions with implications for your pregnancy and birthing. What often happens is that women seen in a consultant clinic lose the normalising effect of midwifery care, with attention focused on the complexity and not on the woman and her developing family. Independent Midwives are able to help you decide if you actually want to see a consultant, which consultant speciality you might need to have a review with, and we can come with you to appointments so that your time there can be spent fully exploring your options. If you develop any complexities during your pregnancy, IMs can refer you to a consultant at the local Trust or elsewhere if appropriate and again come along with you. As IMs have a holistic approach and an in-depth knowledge of you and your pregnancy we are able to help you and your consultant communicate effectively so that a plan which feels right for you can be made.
What happens if I need to unbook?
Most IMs ask for a deposit, some ask for payment upfront, others are happy with instalments. If you have paid me for more care than you have received and you need to unbook due to any reason (miscarriage, house move or just you changed your mind) I will refund the difference based on standard charges for individual appointments (ie currently £200 for the booking appointment and £100 per clinical visit following booking). This might not be the same for other IMs so you need to check.