Pay For An Independent Midwife Or Not?

Mum_of_many_4

Thanks for all these replies, there are certainly some very good points that I will look into/ ask the IM about. Still grateful for any other opinions/ thoughts

inkie

most indy midwives now can't afford the right insurance to be able to practice within an NHS hospital - so they will ONLY be able to accompany you as a support for you, and NOT as your midwife.

Regarding the insurance: as independant midwives are not employees and are self-employed ,the insurance that they require is in effect their own liability insurance which, due to the fact that obstetrics is the biggest claim area for medical negligence, stands at around £6K p.a. This is why most IM do not have it. The NHS midwives are covered by vicarious liability by the trust that employs them - some IM are able to 'practice' in NHS hospitals if transfering their ladies in due to having an honorary contract (i.e. in effect permission to practice to the hospitals policies/patient group directions etc) - if this is not set up for whatever reason, the IM will have to 'keep her hands off'. Therefore, unless your IM has a honorary contract set up, I see little point in 'employing' her for intrapartum care, and would go for the a/n, and p/n care only.

MJMum

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Mum_of_many_4

Yep thats definately what we are trying to avoid.Going to look into this some more over the weekend. Knew I would be given some good advice on here and now I have something to work with.

eleanor_bluefish

lipidicman wrote: »

I heard on the radio the other day (Woman's Hour) that independent midwives are practicing without insurance! Worrying thought!

great you listened to the woman's hour broadcast. There is no insurance available for IM's to buy as it's just not cost effective for insurance companies to provide. Insurance doesn't make midwives safe, by the way. The best way to ensure safety is to have proper one to one care from a known and trusted midwife such as that offered by IM's. Even on the NHS who can offer PII (insurance) you would have to prove that your DR/Midwife had been negligent in some way to get a pay out, a process which can often take many years. What we need is a no fault compensation scheme such as they have in New Zealand and negligence could be dealt with separately by the regulatory bodies such as the Nursing and Midwifery council (NMC)

eleanor_bluefish

inkie wrote: »

Regarding the insurance: as independant midwives are not employees and are self-employed ,the insurance that they require is in effect their own liability insurance which, due to the fact that obstetrics is the biggest claim area for medical negligence, stands at around £6K p.a. This is why most IM do not have it. The NHS midwives are covered by vicarious liability by the trust that employs them - some IM are able to 'practice' in NHS hospitals if transfering their ladies in due to having an honorary contract (i.e. in effect permission to practice to the hospitals policies/patient group directions etc) - if this is not set up for whatever reason, the IM will have to 'keep her hands off'. Therefore, unless your IM has a honorary contract set up, I see little point in 'employing' her for intrapartum care, and would go for the a/n, and p/n care only.

Not sure where you got the 6K figure from? There hasn't been any insurance available at all for at least 5 years and at the last count it was more in the region of 20K

eleanor_bluefish

Jo_R wrote: »

Oooh *rubs hands in glee* one of my favourite topics - giving birth!

I think given the history with the last two pgs, then I don't blame you for wanting to hire an indie midwife. I researched the same when I was pg with #2 but struck lucky with an excellent NHS midwife during my pg and another lovely one when I was induced.

The research I did for my area (East Mids) showed that some midwives will allow you to pay on a monthly basis, basically tailoring how you pay dependent on yr income. Have you spoken to anyone else or just this one? I would definitely research some more and see if you can find anyone who will let you pay like this.

Another option is a doula. They can be your birth support throughout pg and at birth, and you can get postnatal doulas as well. If you know you are likely to need a hospital birth then a doula is another option and not as pricey as a midwive, but offers loads of woman-to-woman support.

One more thing I will say is have you read through your maternity notes? I'm not sure if you know exactly what happened to cause premature labour in your last two babies after three term births? It would definitely be a good idea if you haven't to arrange to read through yr maternity notes so you know wat happened, when and why so you can pre-empt anything at all and be prepared for all eventualities. This way if you do decide to go NHS then you can plan the birth you want as far as you can given the circumstances and knowing all the facts.

I had a 41+1 natural birth with DD1 then a 43 week birth with DD2 so I know all about induction! I fought it to the bitter end but had to have an induction because she simply wouldn't come out! Do you know much about the stages of induction - having your waters broken (not that you would need that), prostin, then oxytocin drip? And the effects each stage has on your body and also on the baby? I just really believe in knowing exactly what you are choosing and what effect it will have - it helps you 'shape' your experience as much as you can if you do give birth in hospital.

Sorry went o/t a bit but as I said, I love this topic of conversation!

Do you think you might have been pregnant forever then? Sounds to me like you have a naturally longer than average gestation which is perfectly normal for you. What a shame you accepted the offer of induction. I hope it was OK

eleanor_bluefish

DrFluffy wrote: »

Couldn't agree more - *only* a med student, but given risk of complications increases massively after 3 births, I also thought you should be entitled to a more intensive level of care, should you so want it. I'm not sure where I stand on the medicalisation of childbirth - will decide when I've been through it - but as there is a real and proven increase in risk you should push more for NHS help...

Dear Dr Fluffy, I'm very curious to know where you learned that there is a massive increased risk of complications after 3 births? This is factually incorrect and not research based at all. I do hope you won't be advising future clients of this?

granadan

There is no evidence to show multiple pregnancies = greater complications. That old chestnut got started in years when food was short, sanitation poor, mothers overworked and malnourisghed and birth control largely unavaialble. Are we really going to erroneaously continue with this rubbish? I am amazed to see it spouted on such an informative site as this one.

Go get an Independent midwife - the cost is NOTHING comapred to the cost of your mental and physical health. Daily, women are abused and assaulted in maternuity units n the name of protocol amnd decreasing litigation. Not in the name of incresed safety! the appalling CS rate has gone up yet the rate or mortality and morbidity has not changed... yet SUICIDE is the main cause of maternal death. Risky risky risky business trusting your sanity, integrity and uterus to the NHS . Ever heard of a sausage processing plant? I was assualted and battered during my birth, even the Clinical Director of Bedford Hospital agreed. Three years later I still wake up reliving it. I thought going NHS would be cheaper than an IM - in the last few years Ive paid more in alcohol to get to sleep without screaming. they nearly killed us both.

theoldwomanwholivedinasho

If you can possibly find the money an indie MW will give you the personalised care and support that is ESSENTIAL in having a good birth. If you can avoid the lottery that is the NHS go for it... Ina May Gaskin (get her books from Amazon) in littigation nightmare US has a Caesarean rate that is lower than the home birth rate in the UK... So much of medical practice nowadays actually causes the very emergency situations they set out to resolve...

Out in the big wide world there is a lot of reseach which says birth is best left alone. If you can't find anything else, talk to any good farm vet about the dangers and costs of interferring in birth and making lots of noise and putting on bright lights. It kills their clients, and it sure as *** messes with people!

You really can't put a price on your sanity, and like Granadan said, I too wake up with nightmares and 4 years on am still traumatised by my hospital birth and unnecessary caesarean. Following my CS I had a beautiful home birth, and I would have paid many times more than it cost to get it!

You and your baby will only get one shot at this, can you afford not to do it peacefully?