Introducing the Childbirth Choices Matter Campaign

AIMS Journal, 2020, Vol 32, No 4

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By Kay King

The UK-based Childbirth Choices Matter campaign has a vision to create a new insurance product for self-employed professional midwives, without being tied to the premiums set by commercial insurance companies, together with an access fund which will allow women and birthing people to access this form of care if they choose.

Self-employed midwives are fully qualified professionals who are registered with the Nursing and Midwifery Council (the NMC), the regulator for midwifery practice in the UK. Point 12 of the NMC Code of practice states that midwives must “have in place an indemnity arrangement which provides appropriate cover for any practice you take on as a nurse, midwife or nursing associate in the United Kingdom. To achieve this, you must make sure that you have an appropriate indemnity arrangement in place relevant to your scope of practice.”

We started our campaign because we saw the need for an indemnity product that didn’t fluctuate with the mood of the commercial insurance market. Since launching the campaign, the premiums required for the indemnity insurance on offer from the commercial market have become so high there is simply no affordable indemnity option available for self-employed midwives. Subsequently, many find themselves unable to practice legally in the UK. This made our aim of launching our own product, independent of the commercial insurance market, even more urgent.

We understand that insurance is absolutely necessary for practising midwives and that the cover should be at a level that represents the claims that could potentially be made. Such an indemnity product obviously requires a significant amount of upfront investment. Our key task at the moment is therefore fundraising, across many streams of income, to support this fully independent insurance product as soon as possible.

Another part of the vision of the campaign was to establish a network that supports midwives wishing to transition into working in a self-employed capacity by choosing to step away from the NHS. It is our belief that midwifery expertise should be grounded in a social model of care, with an emphasis on advocacy, supporting well-being, and protecting public health, and that women and birthing people should be able to choose the model of care that suits their needs.

Some NHS Trusts can make it difficult for midwives to support women in the way they need to be supported and cared for, and having midwives working outside the NHS system has been crucial in enabling some women to make informed decisions about their care when the NHS services have failed to support them. The threat to individualised care has been increased during COVID-19, when women and birthing people’s choices for care within the NHS have been withdrawn or dramatically limited due to fear of infection and a perceived need to centralise resources. This has presented many midwives with a barrier to providing personalised care and has caused upset amongst the midwifery profession.

Similarly, women and birthing people may find it very difficult to have decisions about their care respected by NHS staff, especially if they wish to have care that is not recommended in hospital guidelines. Employing an independent midwife can provide these people with the chance to have the birth they want – but currently this option is beyond the financial reach of many. This is why we saw a need for an access fund for families to use, if they needed it, when they are making choices about their birth care.

So, to sum up, we need a lot of money to achieve this, and we have a team of fundraisers working tirelessly to make it a reality. Over the coming months, we will have lots of different ways in which people can join in to make this long-term vision a reality. We are extremely grateful to everyone who is supporting our campaign.

At its heart this campaign is about feminism. With the creation of a women-led, women-run indemnity product that cannot vanish overnight, as commercial products are wont to do, alongside an access fund to ensure equity, we are committed to working towards returning the choice of caregiver to the options available for all women and birthing people.

You can read more about the campaign here: www.childbirthchoicesmatter.co.uk

Follow us on Instagram @childbirthchoicesmatter

Kay is the Executive Director for White Ribbon Alliance UK. She is a birth activist, doula, and fundraiser.