A rather hurried update for my blog this morning. The coffee
in my system is only mildly adding to the stress I’m feeling at recent events
affecting UK midwifery. And...it’s supposed to be a blessed day off! Give me
strength! I joke that I’ll die fighting for midwifery but surely, and not so
slowly, I’m wanting to walk away before it takes my last breath.
We’ve all had that feeling of not being wanted? Been
excluded by an unfriendly and ‘clique’ gang in the playground? Every single
working day I fight to provide the kind of midwifery I want to see provided by
the UK National Health System. You know the kind of thing, woman centred care,
compassion, continuity of carer etcetera. It works, it saves money, and it
really isn’t rocket science. Our model of midwifery care within the failing and
tired NHS system is no longer fit for purpose. But instead of embracing a good
old shake up, they seem to be happy for us just to creep off into the quiet and
dark to be forgotten about. Who needs midwives anyway?
Hmmm. That’s ONE winge over, but not the one that’s spurred
my need to take action this morning.
You may have seen my earlier posts, a couple of years ago, about
midwives working OUTSIDE of our National Health Service having to find
professional indemnity or insurance? Before this ruling, that all health care
professionals have some form of insurance in order to legally practice, independent
midwives (IM) mostly had NO insurance.
Many moons ago, before NHS, midwives would be paid minimally
or ‘in kind’ by the locals they cared for. With the arrival of NHS, midwives
were directly employed, but still collected a small payment by those who could
afford to pay. This independence has remained, but numbers have massively
dwindled. This decline brought with it a decline in provision of indemnity for
midwives, and at their level of pay (excruciatingly less than obstetricians)
they couldn’t afford the massive expense of obstetric insurance. Royal College of Midwives provided some indemnity cover only until 1994. So, midwives
just informed clients that they had no indemnity should the family wish to
sue for negligence. This was legal, but left the family very much wanting for
compensation, should birth damage occur.
So, our government forced ANY midwifery being provided
outside of the NHS (and this, by rights, includes even phone advice not given
within an NHS midwife’s working hours) to have full indemnity. Some midwives
have agreed contracts with certain NHS trusts. This could arguably NOT be
independent midwifery. IMUK, the biggest independent body of midwives,
thankfully rallied together and made funds available for the necessary insurance. Lawyers at the time deemed this cover to be adequate. End of story, you might think.
However, at the end of last year the NMC ‘decided’ this
indemnity cover was inappropriate. Worryingly, they couldn’t actually tell
midwives what level they thought WAS appropriate. From the moment of that
decision, they deemed independent midwives would be acting illegally if they
continued to support their clients in labour. They were not even ‘allowed’ to
be present at the birth. They could not ‘Doula’, they could not even be a comforting
friend.
Can you imagine the panicky situation this is leaving women
in? Women pay quite a whack of money to have an IM provide their care, and they’ve
often taken this choice because they feel the NHS has failed them. To suddenly be
‘told’ they can’t have their choice of birth companion is utterly abusive to
that woman’s birth choice. I’ve no doubt that incidents of women deciding to
birth alone will increase directly because of the NMC’s decision. This is
helping nobody.
In my mind, independent midwifery is the most woman centred,
holistic, continuous, compassionate care a woman can get. If the NMC do not
work with midwives to provide this, we may as well kiss midwifery as we know it
goodbye.
Do we just go? Quietly? Kicking and fighting? Is it a
struggle just for midwifery? Or for the whole blinking lot of us?
Today I’ve written to the NMC. I’ve heard a lot from friends
and colleagues, and would like to know more facts and check out the reasoning
behind this madness. It feels like a witch hunt. Women birth. It’s what they
do. It keeps the human race going. I bet you’ve noticed. How women birth is
their choice, and it is essential that rights and choice isn’t taken away.
I’ll let you know the response....
''Dear
NMC,
I am shocked, panicked, and totally disheartened by recent
issues between yourselves and independent midwives.
I have been a midwife for many years and follow a family
tradition. It’s in my blood. I struggle on a DAILY, even hourly, basis to
provide true woman centred care within the current NHS. I view independent
midwifery as the absolute essence of being ‘with woman’. I provide a small
amount of antenatal and postnatal care, I volunteer my skills and services, and
provide overseas training to low income countries. I thought I would spend my
last breath fighting for midwifery (It speaks volumes that we should see
continuation of our profession as a constant battle, eh?).
The way I am feeling about NMC’s lack of support and
positive direction for my profession and colleagues, is indeed taking my breath
away. Do we say ‘OK, you win’, and walk away? Does anyone WANT a country
without midwifery? I would freebirth before I put my body and birth in the
hands of an obstetric nurse, and this is what we’ll end up with.
I’d welcome any statements and facts you can provide for me,
which supports your actions. My goodness, I pay enough every year to warrant
your time and attention. Please can you forward these links and information.
Thank you.
Trudy Brock''
Please, share your thought with NMC, your MP's, RCM, hospital trusts, and here.
Links.
Independent Midwives UK
http://www.imuk.org.uk/
Nursing and Midwifery Council https://www.nmc.org.uk/
Royal College of Midwifery https://www.rcm.org.uk/
