What ‘The Business of Being Born’ highlights are the enormous benefits to women and their families of continuity of midwifery care. A meaningful, ongoing relationship between a midwife and a woman on the extraordinary journey from pregnancy, through labour and into motherhood can make the whole experience an empowering and positive one for all concerned.
While midwifery is still very much in the minority in the US and there are new campaigns such as ‘The Big Push’ to increase its presence and/or legality across the country, the alarming reality is that here in the UK, after decades of being the ‘Guardian of Normal Birth’ midwifery - and with it normal birth - is now in decline.
We have taken midwifery care for granted for too long and are in danger of losing it through a combination of increasingly medicalised childbirth - which requires obstetric nursing skills rather than midwifery ones - lack of investment in low tech, community based midwifery services and an increasing shortage of midwives as many leave the profession feeling burnt out, stressed, overworked and undervalued.
Independent midwifery has always been available outside of the NHS as another option for both midwives and women but its existence is now under threat because of changes to Professional Indemnity Insurance proposed by this Government. However, there may be a partial solution….
The Independent Midwives Association (IMA) has noted this Governments’ drive for Primary Care Trusts (PCTs) to ensure that they provide a range of different options to meet the needs of childbearing women in their area.
In line with a growing role for the voluntary and independent sector in providing health services to local populations by contracting into the NHS, the IMA is positioning itself to become one such Provider of high quality midwifery care. A clause in the upcoming Health and Social Care Bill will enable PCTs to offer insurance cover through the NHS Litigation Authority to this new range of Providers.
Midwifery care in this country would be revolutionised by taking it out of the acute medical sector and putting it back into the community. Some of it could then be delivered by self employed, independent midwives offering indivdualised, safe and appropriate care through a Social Enterprise Company, contracting into the NHS.
What is needed is a coalition of women and midwives to make it happen. Women must start demanding such care in sufficient numbers to push Primary Care Trusts (PCTs) executives to commission it. Midwives must be there ready to take up the challenge and offer it. .
Over the years, various policy documents, reports and Health Ministers have highlighted the crucial role of midwives at the heart of maternity services in this country. Time and again a new dawn is promised with women at the centre of care and yet the rhetoric is still not matched by the reality on the ground.
It is now time for the talking to stop and for policy to become action.