How to choose an Independent Midwife

How to choose an Independent Midwife

If you read my previous post – What is an Independent Midwife? – and were considering hiring one then you might be wondering how you would choose an Independent Midwife.  I personally think choosing a midwife (if you’re lucky enough to have a choice) is rather like selecting a partner from a dating site – it’s that level of compatibility that you’re looking for and if you don’t click then that’s fine, but it’s probably not going to work out.

Fortunately most pregnant women hoping to choose an Independent Midwife are going to have a lot in common with Independent Midwives in terms of philosophy of birth and life, so after that it’s mostly just whether there’s a personality clash or not. Initially most IMs offer a free consultation which is a good opportunity for you to suss each other out so even if you’re not entirely sure whether an Independent Midwife is for you it is definitely worth booking a consultation to see if they can offer you what you’re looking for.

How to find an Independent Midwife

Unfortunately you will probably find yourself limited geographically to only a small number of Independent Midwives. The best way to go about it, if you don’t have a word-of-mouth reference from someone you know, is via the IMUK (Independent Midwives UK) website.

There are a greater number in the South East – here in Oxfordshire there are four practicing Independent Midwives, with thirteen more within 50 miles. Areas that are less economically well off or more sparsely populated often have fewer IMs because there just isn’t the client base to support them in their work. If you can’t find one in your area then contact the ones nearest to you and see what their distance limit is. Alternatively you could see if there was a friend or relative nearer the midwife of your choice who would be happy for you to give birth in their house.  Seems extreme, I know, but I do have a friend who did this.

What to ask an Independent Midwife

The first, and one of the most important things, is to see whether your personalities click and if you trust her. You need to be able to fully relax in her care and, if you’re hoping for a home birth, fully trust in her skills and judgment. There are, however, a few key questions you might want the answers to before you make a decision:

• How will my care differ from what I can get in the NHS?
• How long have you been a midwife?
• How many homebirths have you attended?
• What emergencies have you managed at home?
• What’s your transfer (to hospital) rate?
• What is your NMC PIN? (This is so you can check they’re actually on the register, ie: qualified)
• What am I still entitled to and how do you interface with the NHS?
• How are IMs regulated? What insurance cover do you have?
• Why do you work as an IM?
• What is important to you as a midwife?
• What is your philosophy about birth?
• Will my partner be involved in my appointments?
• How will having an IM affect my choices around my baby’s birth e.g. place of birth?
• Can you act as my midwife wherever I have my baby?
• Do you guarantee to be at the birth of my baby? What cover/ support do you have if you are ill or unable to attend?
• Are you planning any holiday around the time my baby is expected?
• Do you work with other IMs and how do you share care if so?
• What can you offer me in my specific circumstances e.g. as worried 1st time Mum, busy second or third time Mum, VBAC, after a difficult first birthing experience, assisted conception, pre-eclampsia, potential breech etc?
• What happens after my baby is born?
• What support do you offer postnatally? What level of feeding support? What level of emotional support?

Final thoughts

The most important thing, though (from my own experience and from asking both my midwives and a number of friends who had Independent Midwives), is not so much the answers to these questions, but the chemistry between you, and your instinctive reaction to the midwife. If you don’t ‘click’ then the chances are it’s not going to work out. This is why turning up at a hospital and having to give birth with whichever midwife is assigned to you is not always a recipe for success.

I chose to hire an Independent Midwife (or, in my case, the Oxfordshire Midwifery Practice which is a collective of three Independent Midwives) for my second pregnancy and birth because I had a very traumatic first birth with lots of medical intervention followed by some very poor (almost non-existent) aftercare which left me with PTSD.

Having done my research and got to know these wonderful midwives both personally and professionally I am enthusiastic and passionate about what Independent Midwives offer to women. I now work with them to promote what they do. This series of posts is written out of that passion and I have received no remuneration for it.

Thanks must go to Sarah Bissell of Wallingford Birthing who assisted me in writing this post by making some of the excellent suggestions for questions that you might want to ask.  Suggestions also offered by the Oxfordshire Midwifery Practice. All images courtesy of the Oxfordshire Midwifery Practice.