The legal role of a midwife encompasses the care of women and babies during pregnancy, birth and the early weeks of motherhood. An independent midwife is a fully qualified midwife who has chosen to work outside the NHS in a self-employed capacity. Often working in partnership with other independent midwives, an independent midwife gives care to a woman and her family throughout a pregnancy and the same midwife cares for the woman as she births her baby and supports the family afterwards.
Independent midwives perform the same antenatal and postnatal clinical assessments as happen within the NHS. Blood pressure monitoring, urine testing and assessment of fetal well being will be completed at each antenatal meeting. Postnatally, your independent midwife will provide information and assistance on infant feeding and care as well as monitoring your clinical wellbeing, helping you to make a full and rested recovery from childbirth.
The benefits of a known and trusted midwife throughout pregnancy and birth (continuity of care) are well known and widely documented. This type of care best helps women to cope with the challenges of labour and the transition to parenthood and reduces the likelihood of having medical interventions.
Independent midwives are on call for the women they care for on a 24/7 basis and appointments can often take place in the evening or on weekends. Appointment times may be longer which can give you a greater chance to discuss concerns or ask for advice.
If you are at increased risk of complications and are unable to find the care you want from the NHS, some independent midwives are experienced in helping women with twins, a breech baby or who have had a previous caesarean to have the birth experience they want.
Although there can be no guarantees in birth, choosing an independent midwife as your caregiver does increase your chances of a ‘normal’ physiological birth.
The majority of births attended by independent midwives are home births but they can also be present at planned hospital births.
Both. Some independent midwives are sole practitioner within their own practice and others work with independent midwifery colleagues under one practice heading. Whatever the working arrangement, at least one midwife will be your known and trusted caregiver with two midwives usually present for the birth itself.
Independent midwives are registered with and regulated by the Nursing and Midwifery Council (NMC) and subject to the same supervision as NHS midwives. Independent midwives are required to keep up to date with their practice and are only allowed to act within their sphere of competence as midwives. All IMUK members hold mandatory professional indemnity insurance.
An independent midwife can be booked at any point during your pregnancy, up to 7 days before your estimated due date.
Browse the IMUK member profile pages in the ‘Find a Midwife’ facility and read more about your potential caregivers on their personal websites. All independent midwives recognise the importance of this ‘fit’ and it is advisable to have a consultation with an independent midwife prior to booking her. Some independent midwives offer this consultation free and others are charged for (with the majority of these fees being reimbursed upon a confirmed booking). It is important to make the right choice for you and your family, an independent midwife will not be offended if you choose to meet several midwives before making your choice.
Many independent midwives offer an antenatal and / or postnatal care only package and often this is explained in more detail on their personal website.
There are very few genuine emergencies during childbirth; this is why research has shown that for most women, birth at home is at least as safe, if not safer than, birth in a hospital setting.
Midwives are expert professionals, trained to recognise any early warning signs that a birth may not be progressing normally and to take the appropriate action. All midwives are equipped and trained for the emergency resuscitation of both mothers and babies and independent midwives attend regular training sessions to maintain and update their knowledge both in this area and in the field of obstetric emergencies.
In case of genuine emergency, independent midwives work in partnership with NHS emergency services in facilitating transfer to hospital and supporting a woman through this time. If a caesarean section is needed, most hospitals will allow women and their partners to be accompanied into theatre by their independent midwife.
There are several reasons for the choice of a homebirth not being offered to some women, some are based on good evidence and some are not. Independent Midwives provide professional guidance and evidence-based information in order for women to make their own decisions. 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.
Independent midwives do charge for their services. The fee will depend on where you live and the type of service being provided. Currently, a complete package of care throughout pregnancy, birth and the postnatal period costs anywhere between £2000 and £5000. Most independent midwives will accept payment in instalments or flexible payment plans and in special circumstances some will consider caring for women for a reduced fee.
Yes. An Independent Midwife has fixed costs to bear and will often have to work harder within a short space of time in order to care optimally for a woman booking later into her pregnancy.
Yes. There are no guarantees in birth and though an independent midwife is passionate about women-centred care and will do her utmost to facilitate your choices, some things are out of her control. Occasionally 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 responsibly 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 will still need to be paid for her work.
Most independent midwives attend births at home, or occasionally in private birth centres. If you are planning a hospital birth or need to be transferred to hospital, you will need to consider the role of your midwife. Very few independent midwives have ‘honorary contracts’ with hospitals and so for a planned hospital birth or a transfer to hospital, you will usually be cared for by a hospital midwife. Your independent midwife can remain with you, but as a birth companion or advocate.
You can receive NHS care combined with that of an independent midwife. 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 or hospital admission if required.