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This is my daughter, an embryonic attachment parent, wearing her baby in a special edition sling created to raise funds in support of German Independent Midwives.

The special edition Pollora POWer Parents sling in support of Independent Midwives in Germany

This sling represents my hope that my daughter will have access to the same level of birth choice that I have today while knowing that it is unlikely that she will.

At least not in Europe.

In 2011 the European Union passed a directive that undermined the ability of Independent Midwives in member states to support a labouring woman. They made it a requirement that Independent Midwives have Professional Indemnity Insurance in the full and certain knowledge that it would be virtually impossible for them to find this cover for an achievable premium.

It confuses me that they would take this step having only just defended the rights of women to choose where they birth because what they have effectively done is make Agnes Gerebs of every Independent Midwife in Europe. They have confirmed the human rights of a birthing woman while depriving her of the effective mechanism to exercise that right, and the result is that women will not easily be able to achieve a safe home birth.

But why does it matter? Why should we care that an Independent Midwife attended homebirth has effectively been rendered unachievable?

It matters because Independent Midwives offer a unique service.

Maternity services within the UK are struggling: That’s not news. There are not enough midwives available to give women proper continuity of care and instead of addressing that problem, this legislation worsens it by removing a small but significant example of best practice. 

What does it leave in its place?

It leaves a service that is already failing 50% of the women under its care while the National Institute of Clinical Excellence talks about providing “a model of care that supports one-to-one care in labour” as if the NHS were just being lazy in not having achieved that already. 

We have to accept that there is a longer lasting legacy of this shortfall.

There is something called Birth Trauma which is slowly eating away at a large number of women like an emotional cancer. 

When I say large number, I mean something in the region of 12,000 women PER YEAR* coming away from the birth of a child with the same symptoms as soldiers who have come back from serving on the front line of a war zone.

Women, like me, who suffer because decision makers at various levels refuse to understand that they cannot dis-empower birthing women without consequence.

These are not women pouting because they didn't get a massage when their back felt a bit ouchie, these are women torn apart by grief because they were failed by the people attending them. 

Effective birth care is about knowing that for all our differences, humans have the need to give birth just like any other mammal; in quiet, respectful environments.

Reversing this landslide of trauma is about making the decision that we as a society value the mental health of our mamas enough not to saddle them with a lifetime of pain and regret.

In order to do that, someone has to get their brave boots on and admit that none of that is achievable with the current state funded models of maternity care. 

It’s late in the day to join the fight for Independent Midwifery but there is still a road to travel before all of this is consigned to the history books.

If you are interested in getting involved, my suggestion would be to look up the Independent Midwives UK group. You can add your voice to many who are working to secure a future where women are able to make a choice that empowers them and gives them access to the respectful care they deserve.

*I know, I couldn't believe the numbers either. Alder et al (2006) put the instance of post childbirth PTSD at around 1.5%. The UK had 812,970 live births in 2012.


Did you have the birth you wanted? Do you feel like it impacted your journey as a parent? I'd love to hear your story.

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  1. AnonymousMay 16, 2014

    Yes, yes, yes. Well written. Good to hear a coherent narrative which tackles why the demise of Independent Midwifery is of import to anyone beyond those fortunate enough to consider using one.

    1. Thank you! I'm glad my message came over effectively. Feel free to share this anywhere you feel it would be helpful :)

  2. AnonymousMay 17, 2014

    However, the NHS is now encouraging births at midwife-led units as well as home births stating that a labour ward is not the place to give birth for a straightforward pregnancy. Alot of choice.

    1. The NICE guideline proposals actually say birth centres for low risk first time mothers and home birth for low risk multips. That doesn't mean it's feasible. I contest the idea that there is choice when the reality is there are not enough midwives to support that choice.

  3. I have to pipe up here and say that I just had my first baby 12 weeks ago at home. I was fully supported through my pregnancy by my NHS midwife in planning my home birth. There are NHS offered homebirth classes, and the NHS antenatal classes I went to spoke about home birth and how it would play out. When I was in labour I called up and a midwife came to my house. I then had an NHS midwife with me until I gave birth (the second midwife didn't make it until just afterwards because of how quickly it all happened!). The care that I received was absolutely fantastic all the way through, including the NHS midwife visits at home in the next few days and weeks after giving birth, and help with breastfeeding, etc.
    I am not saying that there shouldn't be independent midwives, just as there is private healthcare options across the board, but I don't think it follows that women can't have a wonderful, positive birth experience that meets and exceeds their expectations with NHS care.

    1. Hi Jessica Ann,

      First of all congratulations on the birth of your baby!

      I absolutely agree that it is possible to have a wonderful, empowered birth supported by the NHS, as you say, you are living proof.

      However, I would say that it is the exception rather than the rule.

      I spent four years on my local Maternity Services Liaison Committee so please don't think that I'm all about the private healthcare because I'm not, and I have put my own time and passion into helping to defend and improve NHS services.

      I personally feel that NHS midwives are often constrained by the system in which they are employed and feel as if that system is letting down birthing families. In fact, the IMs I know have left the NHS for exactly that reason, and not because they want to get rich.

      My argument, I suppose, is that because IMs are free to create an environment of "best practice" free from the employment policy of a large organisation they are generally better placed to give individual (rather than policy driven) care and that sets mothers up much better to start parenthood feeling empowered.

      I absolutely agree that there are pockets of awesome in the NHS - I went on a march in 2010 to try and save one such pocket of awesome from closure - the Albany midwives if you want to look them up - because I believe that EVERY woman should have a birth that makes her feel like a birthing goddess and not left broken.

      My sadness is that the EU/UK seem to be removing those examples of best practice in favour of the more generalised, easy to manage standards and that those standards are not setting us up well for the future.

      Hope that makes sense.


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