Call the (private) midwife… sorry we don't trust the NHS
01:41 GMT, 11 April 2012
Her bag was packed, grandparents had been summoned, her contractions were coming regularly and Claire Norwood was ready to go to hospital to have her baby.
Along with the usual nappies, baby vests and nursing bras, there was one other essential she was taking with her on to the ward: her own personal midwife.
So mistrustful was Claire of her local NHS hospital, she was taking no chances and had hired the services of an independent midwife to be at her side throughout.
Going private: Claire Norwood, with Ollie, three and Harrison, 18 months. She paid for a private midwife to accompany her through labour
Not being an employee of the hospital and consequently not insured by them, the independent midwife — a fully-trained professional, registered with the Nursing and Midwifery Council, who works outside the NHS in a self-employed capacity — wouldn’t be able to participate actively in the birth.
However, she would be able to act as Claire’s personal adviser, to speak up for her, argue her case with consultants and registrars, and, most importantly, never leave her side.
She’d be there to offer a level of care that only money can buy — cash-strapped and short-staffed NHS maternity units and birthing centres across the country can only dream of such a thing.
There are 8,000 fewer midwives than there were ten years ago, yet the British birth-rate is at a 40-year high — a combination that many fear is putting babies’ and mothers’ lives at risk.
New mum: Andrea Hallewell with Max, six months. She said the main thing a private midwife gave to her was time.
The UK has higher rates of stillbirth than almost any other high-income country in the world, with 4,100 in 2009 — the most recent figures available.
While the causes of stillbirth are varied and often unclear, it has been established that better monitoring during pregnancy and labour can reduce the risk of stillbirth.
It is perhaps no surprise that more and more women are paying for their own private midwife to see them through the birth.
‘It was most definitely the right thing for me,’ says Claire, from Newbury, Berkshire.
‘I felt empowered, supported and, most of all, I felt safe. I got the birth I wanted, supported by someone I knew and trusted.’
Claire, 34, is not one of the super-rich. Far from it. With a young
family to support, she works a couple of nights a week in her local
supermarket to top up the money her fianc Matthew Jordan brings in as a
claims handler for an insurance company.
With the fees for a private hospital,
some of which charge 1,000 a night for a bed alone, beyond their reach,
she considered the cost of an independent midwife just about
Fees are usually around the 3,000 to 4,000 mark for a full, nine-month package covering ante-natal visits, breastfeeding tuition and support in the first month of a baby’s life.
‘Most people wouldn’t mind spending that money on a holiday,’ she says.
‘I never would have considered it money well spent until I experienced the massive difference in care, from pregnancy through to birth and to after-care, women experience with a private midwife.’
It’s an expense for which an increasing number of women, not just the wealthy, are digging deep, according to Eleanor May Johnson, from Independent Midwives UK, which represents 90 ‘sole traders’.
Around 1,000 women paid for their services last year — a threefold increase in just eight years.
Most, she says, opt for an independent midwife to assist them through a homebirth.
Though NHS midwifery units are keen to support women in their choice of birth, the sad fact remains that when the units get busy, sometimes there simply aren’t the staff available to allow for different options.
Yet, increasingly, midwives are being hired by women to support them when they give birth in NHS hospitals.
‘That way they get the continuity of care they want, which sadly a lot of NHS hospital trusts simply are not in a position to offer, as they cannot afford the numbers of midwives necessary,’ says Johnson.
‘Their hands are tied behind their backs. It is really tough on everyone, on the midwives and the women involved.
‘I’m a staunch supporter of the NHS, it is a facility of which I’m immensely proud, with wonderful, hard-working midwives who, believe me, do not want to be running around like headless chickens, unable to offer that continuity of care. It is a concern for everyone.’
As with many women who hire an independent, Claire made her decision following a bad experience three years ago, when she gave birth to her first child Ollie.
‘I believe in the NHS and have always supported it,’ says Claire. ‘When I was expecting Ollie it didn’t even cross my mind to pay for private antenatal care or give birth anywhere other than at our local hospital.
‘The birth followed a fairly typical pattern of medical intervention: I was overdue and induced, my waters were manually broken then, after about 20 hours of labour, I wasn’t deemed to be progressing quickly enough and was sent off for a Caesarean. I got the feeling everyone was simply following protocol to cover their backs.
Busy midwives run around like headless chickens, but it isn't their fault, said Claire Norwood
‘I just did what I was told. I didn’t think I had a choice and didn’t even think to speak out. Afterwards, I felt awful and deflated. It wasn’t what I’d wanted at all.’ But the after-care on the ward was far worse, she says.
‘A puddle of blood stayed on the floor more than a day before anyone cleaned it up, and after several requests for someone to empty my catheter bag, I had to drag myself, Caesarean scar, drip stand and all, to the toilet to do it myself.
‘Then I received virtually no help trying to master breastfeeding, meaning I gave it up after a week. I’m not knocking the midwives. It wasn’t their fault, they were all lovely and tried to help.
‘There just weren’t enough of them and they didn’t have the time to spend with me. It was easier to just offer the baby a bottle.’
Keen to avoid another Caesarean as her due date for her second son approached, Claire started researching her choices.
‘My NHS midwife was definite that there was no way I could give birth naturally following a Caesarean,’ says Claire. ‘But when I started sharing experiences with other mums on online forums, I discovered it could be done. I just needed the right support.’
She found that support in the form of Berkshire-based independent Liz Nightingale, who agreed to accompany her to hospital when she went into labour on October 11, 2010.
‘With her at my side, I felt so much more relaxed and confident,’ she says.
‘I remember an anonymous blur of hospital midwives coming and going, but Liz was there with me all the time.’
Harrison was born naturally at 5pm the following day and, with Liz’s coaching, Claire mastered breastfeeding to the point where the 18-month-old is showing no signs of wanting to give it up.
Many pregnant women are opting to hire their own private midwife who can give them continuous care
But how do the NHS midwives feel about increasing numbers of patients bringing an ‘outsider’ on to the ward to oversee their work
Eleanor May Johnson says that the reaction in hospitals varies. ‘Some welcome you as another pair of hands, and yet others can adopt a “who does she think she is” kind of attitude, which always makes me sad.
‘This isn’t about personalities, it’s about women wanting the best care they can get. We are not there to interfere, we are offering choice.’
This is the approach taken by Jacque Gerrard, the Royal College of Midwives director for England.
‘We value the work of independents, they aren’t viewed as competition, they offer women an alternative and support the work of the NHS.
‘They work to the same regulations, rules and standards as those working within the NHS,’ she says.
‘There is a national shortage of midwives and we are hammering the Government for 5,000 more. It would be wonderful if we could offer women a guaranteed choice, but with the slimming down of numbers, midwives in the community are being forced to take on larger case loads and, of course, that impacts on the kind of care they can offer.’
It’s not just a lack of confidence in staff on labour wards that is tempting women down the independent path. They are also hiring them for one-to-one ante natal care, too.
First-time mother Andrea Hallewell, 39, hired the services of Dorset-based independent midwife Erika Thompson while expecting her son Max, who was born in October.
‘I didn’t get off to a good start with my first ante-natal appointment,’ says Andrea, an IT manager from Bournemouth.
Cuts have meant that midwife numbers have dropped by 8,000 in ten years while the number of births have increased by 40 per cent
‘The midwife didn’t turn up, leaving four pregnant women sitting anxiously in the waiting room for over three hours while someone tried to arrange sick cover.
‘Appointments were always rushed, there were a set number of women who had to be seen in a specific period of time.
‘You got your ten-minute slot and that was that. I thought to myself, this is ridiculous. I am a successful businesswoman, why am I leaving this to chance’
Andrea, and fianc Loic Poirier, a crewing manager for a ferry company in Poole, dug deep into their savings for the 3,000 to hire Erika for the last few months of her pregnancy and the birth, which she planned to have in hospital.
‘The main thing the money bought me was time. Erika was there for me 24/7, I could call her with any niggle or worry and I never felt as if I was bothering her. Ante-natal checks were done at my house and took as long as I needed.’
After nearly two days of gruelling labour, with Erika at her side, baby Max was finally delivered by Caesarean section.
‘I think it was Erika who eventually said: “this has gone on long enough,” ’ says Andrea.
‘Who knows what would have happened if she hadn’t been there’
For Catherine Woodward, 33, a mother of two from Peterborough, her independent midwife brought her something completely different: the fairytale, happy, cuddly moment with her newborn she’d always wanted.
‘My husband Ashley and I were disappointed and upset with our son Alec’s birth by Caesarean section four years ago,’ she says.
‘We felt powerless and stressed, but meekly went along with everything. I was too scared to speak out. Everyone was very nice. I just didn’t know them and they didn’t know me. It was all so impersonal.
‘When Alec was born, he was immediately taken away while I was seen to. We didn’t get our lovely skin-to-skin moment I’d always associated with childbirth.’
Not just for the super-rich: Hiring a private midwife costs around 3,000 to 4,000 for a nine month car package
When she discovered she was expecting a second baby last year, Catherine was quick to hire independent midwife Jane Buckler at a cost of 3,500.
‘I thought it would give me the better chance of a homebirth where I’d be able to relax and let the process happen naturally, as opposed to fitting in with rules and protocol.’
After six hours of labour at home, however, the pain was so intense Catherine opted to be transferred to hospital for an epidural. Yet when Connie was born a few hours later, with Jane at her side, Catherine and Ashley finally got their ‘moment’.
‘As before, there was a paediatrician waiting to whisk her away for checks. Jane spoke up for me and made sure that Connie was given straight to me.
‘She was placed on my chest, I was able to feed her and all three of us cuddled together. It was exactly as it should have been. We were all on a complete high.’
And for Catherine, that moment alone was worth every penny.