Midwifery is one of man’s, or rather woman’s, oldest professions: the skill of passing down wisdom from one mother to the next in birthing a new generation.
Women have always helped each other have babies and, despite the obvious advancements in healthcare that we now benefit from, in many ways not that much has changed in what mothers want from a midwife.
The word ‘midwife’ means ‘with woman’ and represents the valuable bond between a mother-to-be and her trusted and knowledgeable carer during pregnancy, birth and the early days of parenthood. It’s a relationship romanticised by the likes of television drama Call the Midwife when post-war midwives were part of the fabric of local community. Today the picture is somewhat less rosy with the combination of rising birth rates, a shortage of midwives and complex pregnancies that increasingly older mothers sometimes face.
In the UK we are fortunate to benefit from a universal health service available at the point of need, but there’s no doubt that the pressures on midwives within the NHS have a impact on the level of available care. How do the individual needs of each mother tally with the fact that three-quarters of women in this country go into labour without having met thematernity staff who will care for them? It’s hard to imagine.
The Lancet published research late last year to show that outcomes for women with a named midwife were often better than those without. The study of 2,000 Australian women (who have a similar healthcare system to that of British mothers) demonstrated that the women who knew their caregivers were less likely to have a caesarean section, lose large amounts of blood, required less painkillers and often went into labour spontaneously. It’s therefore not unsurprising that the number of mothers choosing the care of a known and trusted independent midwife is on the up. It’s a choice that many middle-class women can and do make, when full, private healthcare perhaps remains out of reach financially, or the mother would prefer to stay within the remit of the NHS facilities, but with the additional support of her own dedicated midwife.
Enter the Neighbourhood Midwives, the first employee-owned midwifery enterprise in the UK. Annie Francis is at the helm of this new venture; an organisation which aims to offer real choice to women and provides caseload midwifery, where a woman receives care from the same midwife from the start of her pregnancy. “It makes no difference if your intention is to hypnobirth at home or whether you’d prefer to deliver in hospital – an independent midwife will provide the support that you need whatever the choice or eventuality,” says Annie. According to Annie, the women who opt for private midwifery are often fit, healthy mothers-to-be with busy lives who are looking for highly individualised care. “They are intelligent and don’t want to have to explain themselves to a new midwife with every single antenatal appointment,” she says. “There is often a high level of fear driving this choice and it is our aim to ensure that they feel supported by someone who knows their thoughts and needs intimately.”
There are approximately 170 independent midwives in the UK, a figure that has doubled over the past five years or so. Whilst legal matters are complicating things for these previously self-employed individuals in recent times (an EU directive that all healthcare professionals must have indemnity insurance is about to be enacted), the Neighbourhood Midwives new employment model of independent midwifery has sprung up in response to the changes, offering both parties protection should they need it. Annie is upbeat about the future of independent midwifery and longs to bring this level of care to the NHS as an alternative provider, perhaps initially to women who have particular needs. “Every woman should have the choice of a positive birth experience with a midwife they know and trust.”
Amy Fanton gave birth to baby Scarlett four months ago and describes her experience of the Neighbourhood Midwives.
“My first birth was relatively straightforward from a medical perspective, but it was traumatising emotionally and left me sceptical of my body’s ability to birth without intervention, fearful that I wouldn’t be able to cope through a normal labour, and afraid of the hospital setting. As soon as I knew I was pregnant with my second child, I knew I wanted to try for a natural birth.
During the prenatal period, Annie Francis and Tina Perridge were amazing at helping me work through these fears and anxieties so that during the labour I was able to just let go. By the time my labour was imminent, I was completely at peace with the possibility that I might end up in the hospital setting I had previously been so fearful of, because I knew I could 100 per cent trust their judgment and expertise. When I finally went into labour at 7am, I was holding my baby girl within two and a half hours after a beautiful home birth and I truly believe a large part of that had to do with the fact that I could be so relaxed because they made me feel so safe. During the labour they were nothing short of brilliant — calm, soothing, loving, positive motherly energy, helping me get back in control when I started to struggle, but also knowing exactly when to stand back and let nature take its course. The monitoring they did was so gentle and nonobtrusive that most of the time I wasn’t even aware it was occurring. They were perfect guides through a challenging but beautiful experience that I will treasure for the rest of my life. They were my epidural, and then some, and definitely my husband’s sedative!”