Independent Midwives: a woman’s right to choose

Ladies,

I hope you can spare five minutes to read about a subject that is very close to my heart and one that needs urgent support from as many people as possible.

Both my children were born at home, as planned. There were no drugs, no intervention, no drama, just good old fashioned relaxation, breathing and the care of two highly experienced and wonderful independent midwives, Mal Soomessur and Jacqui Tomkins.

Now, before you start shouting at the screen, I know that not all birth plans turn out as ‘planned’ and that medical intervention is sometimes needed. I do not intend to discredit the NHS, push for homebirths, natural births, increase business for Independent Midwives or even suggest that you should have a baby at all in some cases! What it is, is a plea to help save a woman’s right of choice.  Hence why I have sent it to all the wonderful women I know, please read on….

The service offered by Independent Midwives (IMs) is shortly to become extinct. Our Government, governed by Europe, is making it illegal to be registered without insurance. This is fine for other healthcare professionals as insurance is easily obtained but no such insurance exists for IMs. This is because there is only a small number of IMs in the UK, hence the premiums make the insurance option untenable.  This means that from October of this year, the choice to use this incredible service will be taken away from women.

The government is bound by European directive that says that all member states must ensure the same level of indemnity cover for each citizen across all borders. However, every member state has a different way of implementing maternity care. Some will have limited state medical provision and others like Germany will have none. It has been agreed that each member state’s government will be allowed to choose how they implement the agreement to provide indemnity cover.

That means that our Government could help IMs comply with the ruling, if they wanted to, however they seem to be disinclined to do so, despite being supportive when in opposition. This reduces the choice for women and families even if, like me, they choose to opt out of the system and take responsibility for their choices by signing a statement agreeing to work with IMs without insurance.

The Royal College of Midwives could also help the IMs but they have chosen not to as ‘they feel that the NHS is somewhat undermined by the gold standards of care provided by the IMs’. A standard which the poor, under-funded, overstretched NHS cannot achieve.

The bottom line is that if the choice to use IMs disappears, then the NHS has no comparative service and can provide all the mediocre care it wishes.  It will also have to burden the cost of all births that currently happen outside of the NHS.

IMs are also the keepers of vital midwifery skills that have been lost to the NHS as a whole. Normalising twin and breech births can only happen if there is a confident, competent practitioner helping a woman through. If those skills are unavailable then it becomes unsafe to offer women choice over their birth process and we are left with what the NHS offers now; Caesarean section only.

In 1994 the Royal College of Midwives discontinued Professional Indemnity Insurance (PII) for IMs, stating that it was too expensive and members were not in favour of the increase in premiums. By 2002 there was no commercial insurance available either, as the premiums were far more than any IM earned, not because of high payouts, but because there were simply not enough IMs (roughly 80 and falling!) to pay premiums. Up until today IMs have been practicing midwifery with no PII but with the knowledge and agreement of the women for whom they care, but the directive takes that choice away from women.

The solution being fielded by the Coalition Government is through Social Enterprise or Franchise and Private Companies using the “Any other provider” status to contract IMs into NHS trusts. This doesn’t really solve the problem for women like me who want to choose care outside of the NHS and also for those Midwives who prefer smaller, manageable caseloads that work around their family lives. The selection process is also rather vexatious; no first timers, no twins, no breech, no previous c-sections – the list goes on.

The campaign group for Independent Self Employed Midwives has asked the Government to look again at The EU directive or help source Professional Indemnity Insurance that is workable and affordable.

IMs are not women who have woken up one morning and decided to be midwives. They are midwives with 25/35/40 years of midwifery experience who have left the NHS as it does not cater to creative thinking or naturalisation of birth, rather seeking to medicalise it.

To stop them from being registered would be a huge loss to the families they can help. It also leaves women with less choice.  A choice that I believe is a human right.

For women, like me, who want to labour peacefully in their own home with minimal medical intervention, checking, coaching etc the choices are, sadly, to be limited from October this year.

I think it is totally wrong for a Government in a free society to take this choice away from women and to dictate how she should give birth by setting measurements, parameters and strict guidelines.

These incredible midwives are highly skilled, amazing women, whose main passion in life is to empower strong, wonderful women during childbirth. In my opinion, to lose this fantastic service would be a catastrophe.

I laboured at home, no drugs, just breathing.  Connie’s was the text book HypnoBirthing birth, beautiful, peaceful, a totally amazing experience.  However, at times both of them were tiring, even frustrating, especially second time round.  Eli was quite comfortable with his hand on his head and was only going to be born in his time.  For those of you that know him, you’ll know that he still is the most laid back baby in the world. To quote Mal ‘everyone runs a marathon in a different time’ and Eli was in no hurry to get to the finish line.

Thankfully, because I was under the care of IMs, they were able to be guided by the welfare of me and my baby, rather than figures and measurements. Had I have been under the care of the NHS, it would have been deemed that my labour was not progressing fast enough and there is a high chance I would have been given drugs or had my waters broken to speed up my labour, pushing Eli to be born without having a chance to move his hand down.  This is very likely to have resulted in him getting ‘stuck’ and me ending up with a c-section.  I was determined to avoid any intervention as I was carrying Step B, which, had I have passed on to Eli, could have resulted in devastating effects.  But, with the calm reassurance and expertise of my midwives (oh and a lot of stern words from my sister) we gave Eli the time to move his hand and he was born safely and happily with no intervention at all.

I know my choice of birth may be totally different to others and I appreciate that many women have a perfectly happy experience with the NHS but please help us to keep that choice open.  If not for me or you, then let’s fight for the freedom of choice for any woman who will need it in the future and keep it that way for our daughters and their daughters to come.

There is a petition and a number of Facebook pages that are looking at how to campaign and think up other solutions but they are running out of time…they need women to stand up and say NO to the reduction in our choice of carer and provider.

Please, please, please Sign the petition here if you are supportive and pass on to any others who would be happy to do so (men included of course).

For further information there are a number of links below.

Independent midwives uk
Fighting for independent midwifery
Homebirth uk
Human Rights in Childbirth

Thank you for taking the time to read this.

Amy