Independent Midwifery: Dispelling the Myths

"I bet your clients are really demanding?".  Sigh.  Nope, not usually.  In fact, I find the hardest bit of being an IM is dealing with such misconceptions and answering questions (from an NHS midwife) as that one.  I wrote previously about 'what we do', now however, it is time to dispel some myths about Independent Midwives (IM's):

IM's are Maverick and Risky
On the contrary; IM's have a large number of women who would be considered 'high risk' within the NHS and as such are seeking a midwife who will support them in their informed choices.  This means careful thought and planning, often involving a Supervisor of Midwives to help arrange the appropriate care.  It means being up-to-date with the latest research so that we can provide safe, effective practice.  There are risks to our job; but we work hard to keep these to a minimum whilst supporting women fully in their choices.

Women who use IM's are wealthy
Different women, from different backgrounds and with differing levels of personal income book with IM's.  Yes, I have had clients whose disposable income is enviable, however the vast majority of my clients have to work hard to find the money for my fees.  Or they simply can not find the money and then we try to work something out.  For most clients, their priority is to book with a midwife whom they know and trust  - and this often means making huge personal sacrifices.

IM's earn 'loads of money'
You can see that in the shiny 2005 Citroen Picasso I drive, and all the holidays I take - NOT!  Out of my fees I have to pay for my equipment, administration costs, petrol, training updates, tax, holiday 'pay' (being self-employed means when I am not working I am not earning), journal subscriptions,  etc etc.  IMs really do not earn huge sums - and we really do earn our money!  24-on call is not an 'easy' option and can take it's toll on family, friends and day-to-day life.

IM's Clients are demanding
If wanting to have one-to-one care with a midwife you know and trust, appointments in your own home, and feeling supported in your choices is considered 'demanding' then yep, my clients are very very demanding.  I do find however that this standard of care pays dividends in normal outcomes, high breastfeeding rates and family satisfaction.  And I always get tea and cake (hence my expanding waist line).  Women are really so demanding!

IM's don't want insurance
We do, we do, we do!  We just can't get it!  Honestly, every time you go to a birth, to hear the little voice on your shoulder saying 'this could be the one that costs your home' is not fun!  We do it because we can (not for much longer), we do it because we care, we do it because midwifery services should not be a 'one size fits all' option.  I do it for myself (terribly selfish), but knowing who I am going out to when I get called to a birth makes me feel like a safe practitioner.  Plus, I don't have to get to know the woman and her family, instead I can just offer my full attention and be 'with woman'.  It's fantastic.

Independent Midwifery is not for everyone, just as being a labour ward midwife, or a consultant midwife is not for everyone.  The important thing is that just as women should have choice, so too should midwives.  

There are many myths around Independent Midwifery and IM's, and the one that is most concerning is that is does not matter if we are no longer able to practice.  The demise of IMs will have catastrophic affects, and midwives within the NHS will find that their autonomy will be significantly threatened - the RCM know this and just continue to play footise with a government that is calling the shots.   Just look to countries where midwifery has been persecuted in this way, and then see how many midwives there are.  It is worrying.

Independent Midwifery must survive - and you can help.  You can share this blog with everyone and anyone who has an interest in midwifery or birth.  You can tell people the TRUTH about IM's.  You can watch 'Home Delivery' on March 21st and see how we work.  You can join our facebook page and learn more.  Women matter - IM's do too.

angela xx

fear + loneliness = Brave?

I have often been told that I am 'brave' for choosing to be an Independent Midwife; I wrote about this a long time ago and can honestly say I have never felt brave, or really understood why fellow midwifery colleagues consider me such.  I am just a midwife, working to support women, some courageous and strong, some needing support to find their inner strength, but all who wish to have the bulk of their care outside of the NHS system, with a midwife they know and trust.

I attended a beautiful home birth this week; I was not anticipating to be the primary midwife, but the woman's own midwife was caught in Jury service and unable to attend. I gathered myself together and headed off to the birth - I knew the woman and her family having supported them as the second midwife with their first baby.  As always, I mentally prepared myself, and drew inner strength and calmness into my being.  I was not aware that I would be doing that many times in the course of the woman's labour..........

Birth works: if you follow my blog you will know that this belief is deep in my inner core.  BUT, and there is always a BUT in nature, sometimes birth changes and sometimes nature will challenge us, humble us and remind us that she is a force that we cannot always control, always predict, always guarantee.  After the baby made its way earth-side (a beautiful, calm, wonderful HVBAC), the woman's body was not (for whatever reason) willing to release the placenta; I was concerned.  Too much bleeding necessitated a decision to transfer; a serious maternal obstetric haemorrhage occurred,  a wonderful team of NHS staff worked very hard to save a very compromised mother.  And a very shaken midwife was left holding the baby...... until he was safely tucked back with his mother later on that day.

So, back to my 'bravery'; it was with a sudden clarity that I understood why people believe me to be brave - and it has nothing to do with me.  As I watched the team work around the woman (and I was in total awe of the NHS staff and so very, very grateful that when obstetric care was needed, we had access to it), as I supported her, reassured her, even prayed for her, I have never felt so alone in all my life; the safety net of the NHS is a strong one.    Perhaps this is the reason midwives do not challenge guidelines, or policies not based on evidence; perhaps this is why the vice on midwifery is so strong.  Not that I am brave, but because the 'safety' of working within the NHS is so strong - and watching that team, I think I understood why people would not want to 'risk' that.  Being the lone voice, choosing to leave that safety net, to be fully autonomous, to accept full accountability..... can be very lonely indeed.  The fear of loneliness is why people believe I am brave.

I am not 'brave' for choosing to be an Independent Midwife; it is a wonderful way of working.  It is 'the gold standard of care'.  It is rewarding, challenging, exciting, scary, bumpy, amazing, tiring.  It is working to keep birth normal - and safe. I am not brave...... but if more midwives were given the support to work outside of the NHS, if the government fully supported choice and continuity, if the RCM would acknowledge a group of midwives who work outside of the system, it might be a little less lonely.

angela xx

He who is brave is free. 

Lucius Annaeus Seneca 

Read more at http://www.brainyquote.com/quotes/quotes/l/luciusanna121145.html#vPE1uJcEvV29CUTm.99