Independent Midwives and Insurance

Since 2002, there has been no professional indemnity insurance available for
Independent Midwives for childbirth (professional indemnity insurance
includes medical negligence). There is cover for antenatal and postnatal
care. The reason we cannot obtain insurance for birth is because
'obstetrics' is considered to be very high risk by insurance companies, and
a payout for a single damaged baby can run into millions. As there are only
approximately 150 independent midwives in the UK, we could not put enough
into an insurance pot to pay for even one claim.

Lack of insurance does not mean lack of safety. Our statistics for outcomes
are excellent and are often quoted as demonstrating a 'gold standard' of
maternity care. We pride ourselves on a very good level of communication
with our clients, and also on the highest standards of training and
professional development.

I have been able to obtain professional indemnity insurance to cover my
practice for antenatal and postnatal care, but as there is no insurance
available for births, clients must be aware that for a homebirth, there will
be no insurance cover.

Thus, for a homebirth I would be insured for antenatal and postnatal care,
but not for the actual birth. For clients wishing to have a hospital birth,
the birth would be attended by a hospital midwife with me in a supportive
role only, and thus the hospital birth would be covered by the hospital's
Clinical Negligence Scheme (basically the same as insurance).

The fact that we don't have insurance does not mean that there is no
statutory protection for women. All midwives including independent midwives
are subject to very stringent regulations. We each have a Supervisor of
Midwives, and have at least one statutory supervision meeting a year, when
our practice is reviewed and our equipment is inspected. We have to abide by
the Midwives' Rules, and other regulations which are strictly monitored by
the Nursing and Midwifery Council.

The situation is under review by the Government at the moment, and
legislation is currently being formulated which will make it impossible to
register as a midwife without full professional indemnity insurance.
Obviously this would put all independent midwives out of business. We have a
campaign which you can read about on www.saveindependentmidwifery.org , and
please do sign the petition. In the meantime, we continue to practice
although feeling very vulnerable, because we passionately believe that women
have the right to one-to-one care, and to the highest possible standards of
care.

Excerpt from www.saveindependentmidwifery.org:

Independent Midwives have been unable to obtain insurance on the open
market, but are experiencing increasing demand for their services from women
who are looking for a greater level of support than the NHS can always
offer.

. Independent Midwives have been forced to practice without professional
indemnity insurance (PII) since 2002 when the last commercial insurance
product was withdrawn from the market.

. Insurance is unavailable due to the small number of Independent Midwives
and the potential for very high claims, even though there have been no cases
of significant awards against Independent Midwives in the UK since 1994.

. Independent Midwives have not wanted to practice without insurance; but
have had no choice.  All Independent Midwives explain the situation clearly
to clients to ensure they understand that they will not have significant
recourse in the event of a negligence claim.

. This is a situation that our clients accept, which underlines the
importance they attach to the level of individualised care and support that
Independent Midwives are able to offer compared to NHS midwives.