Please Help Save Independent Midwifery by commenting on the Professional Indemnity insurance consultation document

A public consultation is now open to the public until the 17th May 2013. It is your chance to say why professional Indemnity Insurance should not be linked to Midwives registration. This will have far-reaching implications after 25th October when it will become law – unless we can convince the powers that be to not implement it. This is where you can help by commenting on the consultation document. It is a long and wordy process and the issue is hard to get your head around unless you know the history so read a short version here at Birthrights

Question 6 is the most important one, but answer as many questions as you can.  Below are some of my comments. Please feel free to use any part of this to help you phrase your own answers:
“Linking Professional Indemnity Insurance (PII) to midwifery registration will discriminate against Independent midwives. Independent Midwives will be unable to purchace professional indemnity insurance as they are self employed. They are not part of, and most do not want to be part, of a corporate structure. They have chosen to work independently of the NHS to provide a better quality of service to women. As individuals it is impossible to purchase PII.
It suits many Independent midwives to be self-employed for many reasons. Continuity of carer provides better outcomes, and working this way means being on call for all the births on your caseload. The commitment to attend every booked birth requires the ability to re-scedule planned appointments on a daily basis. Many independent midwives also have young children/ elderly parents to care for, and working independently gives a greater flexibilty to their working day. Working for the NHS doesn’t offer this provision.
Women choose Independent Midwives for many reasons, but the majority have found their needs are not met by NHS care. Another group have had bad experiences with the NHS in previous births and need an alternative. The restrictions that insurance companies place on care is the reason many women opt out of NHS care. These same restrictions will apply to the care independent midwives can provide if indemnity insurance becomes compulsory. Just because something is high risk doesnt mean women should not have the right to do it.
The court of human rights have ruled that women are able to choose the circumstances of their birth including where, and with whom they choose to give birth. Making it impossible for midwives to practice independently without insurance is removing women’s human rights!
And what about the rights of Independent Midwives to work and provide for their families? is that not a human right too? Hundreds of Independent midwives will lose their livlihoods, thousands of women will be denied individual choice in pregnancy and birth if it becomes illegal to practice without insurance.
Independent Midwives are highly skilled in facilitating normal birth, including breech birth, and physiological third stage. These skills are in short supply in the NHS leading to an ever increasing caesarean section rate. Caesarean surgery carries serious risks and makes subsequent births high risk – costing the NHS extra time and resourses used, and in compensation claims. Wouldn’t it make sense for the NHS to save money by government supporting the contribution Independent midwives make to the normal birth rate?
I’m afraid that independent Midwives will not simply join the ranks of their NHS colleagues, they will leave the profession. One colleague recently told me she would rather die than return to NHS hospital midwifery. I know that sounds over dramatic but it’s not. Having worked as an Independent midwife for 7 years I understand how the same level of Midwifery care is impossible to achieve on the NHS. Independent Midwives pride themself on their professionalism and high standards – and to some, returning to NHS work would mean lowering those standards. It is impossible for many independent midwives to contemplate returning to giving piecemeal care, on under-staffed wards, with not enough time to provide quality care. It would break many midwives hearts to have to work this way, seeing the daily distress of women uninformed in pregnancy, left alone in labour and unsupported in their attempts to breastfeed.
Without an option to NHS midwifery care women will look for alternatives. I have already heard of the growing movement of unassisted births and women giving birth with doulas, are we to add qualified but illegal and unregistered midwives to the list of choices?
  Many independent midwives want women to be financially compensated for negligent care but fear the restrictions insurance companies will put on the type of care given. Is there any way a no-fault compensation scheme could be provided for these families? I understand there is such a system in New Zealand.
I am truly saddened to think that when my daughter gives birth she will only have the option of NHS midwifery care or illegal birth attendants.

In response to the question on cost I wrote:

“I do not have the necessary monetary cost data to hand, as I’ve been a caring, professional midwife for 12 years, not a politician, statistician or… research fellow.
The important costs that I’ve witnessed are not just of monitary value, so may not be viewed as valuable to this consultation, but they are of paramount importance to women and their families! Women and their experiences should be at the centre of this consultation rather than how much the monitary costs to the NHS will be.
I care for women. I care about what quality of life they have as a consequence of the maternity care they’ve received. I care about the unseen cost of dammaged women and how that impacts on their children, relationships, and our society in general. What cost is there to the traumatised woman who sees herself as dammaged, and unable to realise her own potential as a result of her birth trauma. What cost in terms of postnatal depression, child neglect and abuse, the need for foster care and the potential for future criminal behavour, maternal self harm and even suicide. Suicide is a leading cause of death for women in the period around childbirth. What cost to the children who have lost mothers and partners who’ve lost the love of their life? Do these costs count for anything under our current government?
If you’d like to hear about direct financial costs I’d like you to consider the additional future costs to the NHS of caring for  thousands of women previously cared for by independent midwives. These are often women with complex physical and/or psychological needs, requiring specialised one to one care, to ensure optimum outcomes. Without this specialised care, women have the potential to be further traumatised, with the consequenses already mentioned above. Lack of compassionate, one to one care for vulnerable groups also holds the potential for women who’s needs are not fully met, to sue for negligent care – costing the NHS millions in payouts and increased insurance premiums.
And what about other specialised groups such as those wishing for a peaceful breech birth, or vaginal birth after caesarean? Breech birth skills are woefully lacking in the NHS, and women are informed (often because there is no one knowledgeable or skilled to help with breech birth) that they have no alternative but to undergo abdominal surgery (with all the known risks) to deliver their baby. Independent Midwives are highly skilled in caring for women choosing these types of births. It is well known that surgical birth costs more than straightforward vaginal, midwife-led birth. The complications associated with caesarean surgery cost the NHS much more than normal birth, and the longer term costs of such complications are far reaching. The short term costs of preventing and treating wound infections, and giving blood transfusions are well documented. The longer term costs of caesarean surgery may not be as easy to cost. Treating subsequent postnatal depression (and the future cost implications for the child), further surgery to divide adhesions and the increased risks (and associated costs) on future pregnancies also need to be costed in. A broader view also needs to be taken of the cost implications of women who’ve had a caesarean being less likely to breastfeed. Children who are not breastfed are prone to many more health problems, at huge financial cost to the NHS!
Independent Midwives are highly skilled in facilitating normal birth so wouldn’t it make sense for the NHS to save money by government supporting the contribution Independent midwives make to the normal birth rate?”

I don’t have the comments I wrote on whether this will discriminate against anyone as I was so mad at this point to remeber to copy it. Needless to say it was a lengthy post.

Please, Please comment and ask as many people as you can to do likewise. The more people who bother to add their comments, the more potential we have to halt this requirement to link PII to registration before it becomes law. Respond to the government ‘consultation’ with your views 


Join the Facebook group: it doesnt take long and you’ll receive up to date information as it happens.

Email your MP now, find who your MP is here:

Sign the petition this takes just seconds to do.

Ask the Royal College of Midwives union to support us

March with us on the 25th March in London. It will be a peaceful protest to highlight our campaign. The more people attend the more the Government may take us seriously. More information here:

See what this type of care means to women;

here in this Independent article written by a woman who’s given birth with independent midwives twice.

and here on you tube where a woman discusses the importance independent midwifery made to her when her baby was born breech.

There is also a plea from a well respected obstetrician to leave Independent Midwives alone.

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