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About independent midwives

What is an independent midwife?

The legal role of a midwife encompasses the care of women and babies during pregnancy, birth and the early weeks of motherhood. An independent midwife is a fully qualified midwife who has chosen to work outside the NHS in a self-employed capacity. Often working in partnership with other independent midwives, an independent midwife gives care to a woman and her family throughout a pregnancy and the same midwife cares for the woman as she births her baby and supports the family afterwards.

What kind of care does an independent midwife provide?

Independent midwives perform the same antenatal and postnatal clinical assessments as happen within the NHS. Blood pressure monitoring, urine testing and assessment of fetal well being are completed at each antenatal meeting. Postnatally, an independent midwife will provide information and assistance on infant feeding and care as well as monitoring clinical wellbeing, helping the women they care for to make a full and rested recovery from childbirth.

What are the benefits of independent midwifery care?

The benefits of a known and trusted midwife throughout pregnancy and birth (continuity of care) are well known and widely documented. This type of care best helps women to cope with the challenges of labour and the transition to parenthood and reduces the likelihood of having medical interventions.

Independent midwives are on call for the women they care for on a 24/7 basis and appointments can often take place in the evening or on weekends. Appointment times may be longer allowing for holistic care and for a trusting and effective relationship to be built.

What are the benefits of working independently?

Many independent midwives cite being able to give the highest standard of individualised and continuous care to the women they care for as the most rewarding aspect of independent practice. Getting to know clients and their families is at the heart of independent midwifery.

Working independently and choosing your own caseload also affords practitioners their own work / life balance. The wonderful job of midwifery really does remain a joy throughout a career when it can co-exist harmoniously with life’s commitments.

How do Independent midwives work?

Where do independent midwives work?

The majority of births attended by independent midwives are home births but they can also be present at planned hospital births.

Do independent midwives work alone or in practices?

Both. Some independent midwives are sole practitioner within their own practice and others work with independent midwifery colleagues under one practice heading.

How is an independent midwife regulated, supervised and insured?

Independent midwives are regulated by the Nursing and Midwifery Council and subject to the same supervision as NHS midwives. Independent midwives are required to keep up to date with their practice and are only allowed to act within their sphere of competence as midwives. All IMUK members hold mandatory professional indemnity insurance.

How do I find clients?

Becoming a member of IMUK enables you to add a listing to our national database which is many potential clients’ first port of call in finding an independent midwife caregiver. You may choose to also undertake your own marketing via a personal website etc and there are several IMUK workshops which support those members new to reaching their client base. Word of mouth is a very powerful tool and you may find that one good birth leads to another!

What is an independent midwife’s role during a birth?

An independent Midwife will sometimes be with a woman for a long time once labour starts. Her role changes depending on a woman’s needs. Sometimes she needs to be hands-on and sometimes she just sits and observes.

Becoming an independent midwife

Can an NQM become an independent midwife?

Yes. As a fully qualified midwife you have the requisite skills, but initially you will need the support and expertise of more experienced practitioners. IMUK will help by providing access to our online support boards and by facilitating access to our workshops and study days.

I have no experience running a business, can I become an IM?

Yes. The majority of our members had no experience of business before making the decision to work independently. As with any other form of self employment, there is a learning curve but there is plenty of support available both from within the organisation and outside it.

I am interested in becoming an independent midwife. How do I find out more?

Attend an IMUK ‘Making the Move’ workshop and talk to Independent midwives in your area about whether or not it’s the right choice for you. There are also a couple of good books which you may find it helpful to read. ‘The Independent Midwife’ by Lesley Hobbs answers many questions about independent midwifery and Virginia Howes’ memoir, ‘The Baby’s Coming’ details many career highs and challenges in the life of an independent midwife.

What is the average caseload of an Independent midwife?

The average caseload per independent midwife is around 10 with the larger practices caring for around 30 women per year. Circumstances may change throughout careers and so caseloads often adapt to reflect life changes. Choice is a fundamental philosophy that underpins the care independent midwives give to clients and how they manage their working lives.

Working Diary Examples

Angela’s working diary

Practice: Own practice
Caseload: 12-15 women per year

Week 1: 6 hours
Week 2: 10 hours
Week 3: 20 hours (including a birth and facilitating a workshop)
Week 4: worked 8 hours

I have been an independent midwife since September 2007 and home educating my 3 children since August 2011. I carry a medium case load of around 12 – 15 women per year, which works well with my family commitments.
I tend to offer appointments in the afternoons, evenings and weekends (mornings are spent with my children on their education) and I find this works really well for my family and the clients. I have rarely missed events that we have planned to attend, and although three of my family members now share their birthdays with baby’s I have ‘caught’ (!), the impact on the family has never felt ‘too’ much.
I try never to work on Sundays unless a baby is on it’s way or it is an early days postnatal visit, and I can normally ensure I get at least another full day off in the week. I am sure that as I become less needed by my children, I will be able to work longer days and have more time ‘to myself’, but for now the balance feels about right.
Some weeks can be really busy: if two babies have arrived close together then you know that you will have lots of visits to do; but this is balanced by the ‘down-time’ you get in-between clients and I ensure that I have a few months off-call each year so that I don’t get burnt out.
I love this way of working and feel so privileged to work in this way; yes being on-call has it’s challenges, but I don’t have to work long shifts and I can plan my diary to suit me. It’s wonderful.

Sarah’s working diary

Practice: Own practice
Caseload: 30 women per year

Week 1: worked 58 hours
Week 2: worked 40 hours
Week 3: worked 24 hours
Week 4: worked 24 hours

Working as an independent midwife gives me the freedom to work as I choose. I have an average annual caseload of 30 clients, which compared to some is quite high, but I still manage to have 2 months in the year work free. I usually book the whole of June and September off. This means on average I have 3 clients due each month.

My week is usually comprised of two very full days, when I may start at 8 am with my first visit. Some clients wish to have an ante-natal appointment at this time of the day, before they go to work.  Each visit will last a minimum of an hour. I value this opportunity to build up a relationship with clients. I cover a wide geographical area and may have a 40-60 minute journey between clients.

I am happy to do evening appointments and prefer to work a couple of really long days and then have days off.  Busy days will usually consist of a maximum of 6 visits, both ante and post natal. The rest of the week may be my own. I rarely work weekends except for births of course.

I run an aqua natal class on Wednesdays and at other times there may be meetings or study days to attend. There are also phone calls to make, letters to write and e-mails to answer.

Then of course on average 3 times a month I will attend a birth, and this may be anytime from 6 to 26 hours. If it is on a day when I am due to work it throws everything out for a day of two but I soon catch up and clients never mind changing appointments at the last minute due to a baby being born as they know one day that will be them. All that is explained to them at the outset. I am on call 24/7 for clients but they never abuse that. I only ever get calls that are important and while I may have to leave a shop to chat to a woman or interrupt a movie etc, it is rare and because I know the woman it never feels like an imposition.

The beauty of being an Independent midwife is I can work as much or as little as I wish that suits my circumstances. I can take last minute holidays too if I have no clients due. It is all a matter of choice and good planning, but running your own diary rather than being told when you have to work is very rewarding.

My children are grown so I do not have to worry about childcare but can see that even if I did I would be spending more quality time with them as I am home most evenings and weekends.

In 10 years of independent practice I have never missed a Christmas although one baby was born at just after midnight on Christmas Eve so I can still say I have been at a Christmas babys’ birth.

I once arrived at a birthday celebration and got called away just as I opened my first present so they had to all celebrate without me. A few hours later I rang my birthday guests and let them hear the baby cry…a cheer went up around the restaurant so it made it all worthwhile and I still get a card from that family on my birthday every year. That was the only family celebration I missed in 10 years.

Students

Work Experience

IMUK receives many enquiries from student midwives and from aspiring midwives looking to gain a wider understanding of the role of the midwife. If you are a student midwife or looking for work experience and are interested in shadowing an independent midwife in her day to day work, please use the ‘find a midwife’ search and then contact the IM’s who live closest to you. Please remember that IM’s receive many requests and are usually unable to accommodate all of them.

PLEASE NOTE: Students who shadow us will not have vicarious liability for Professional Indemnity Insurance (PII) and are therefore unable to undertake any clinical care. They would be there in a purely observational role with the consent of clients.

 

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