The main reasons that people give for considering using an independent specialist midwife is that they want extra care or support that isn’t readily available on the NHS. They want to have more flexible (and longer) appointments, and want to see and get to know one midwife who can support and guide them throughout pregnancy, labour, birth and beyond. In the UK, most women will be able to access free NHS services. The NHS is working to develop continuity of care for pregnant women, so do ask your NHS provider what they can offer in your particular circumstances. The Royal College of Midwives (RCM) guide to continuity details what NHS Trusts are working towards.
If you choose to employ an independent specialist midwife, you are not “opting out” of the NHS system, you retain the right to the full range of NHS services and specialist input. You can have the best of both worlds!
The National Childbirth Trust (NCT) have put together a useful guide which can help you think through what you might want from an independent midwife.
The initial thing to clarify is what in particular you are looking for, and to check that the midwife you choose has the right level of skill and knowledge for your anticipated needs. Does the midwife have contact with other specialists if your needs were to change?
Walking With You offers general midwifery services, but is primarily a independent specialist midwife service for those facing concerns about their baby’s health and development in pregnancy. When an antenatal screening test result suggest a “high risk” or “high chance” of a condition, or a fetal abnormality (anomaly) is suspected or identified through an ultrasound scan in pregnancy, pregnancy suddenly becomes very complicated. As a specialist midwife, Angie’s focus is on supporting parents to get, understand and process information and then to make the decisions that are right for them. Sometimes parents will be able to use the information gained to prepare for a baby who is different from their initial expectations (such as a baby affected by Downs syndrome). Difference is not always “bad” or “a problem” – indeed it is often the variety in society that makes life so interesting. Angie can help families get the best possible start, through information, introduction to support groups and planning the birth and early days management for their baby. This is in addition to the usual work of a midwife, monitoring the health of mother and baby and preparing for and supporting through labour and birth. Find more information about services here.
Continuing a pregnancy when baby is known to have a life limiting condition has been a relatively unusual choice in the UK in recent years. Of course, our ability to find fetal anomalies has increased hugely in recent years with developments in ultrasound scanning, prenatal genetic testing and so on. In the past, many of these conditions would not have been known about until birth (and some not even known until years later, if ever). Being faced with the option whether to continue the pregnancy or whether to have a termination (termination of pregnancy for abnormality or compassionate induction) presents great moral, ethical and religious issues for many people. Often in UK practice there is an assumption that if a baby has a certain issue (such as anencephaly, trisomy 18 or bilateral renal agenesis) that a termination will be required. In this situation, a skilled independent specialist midwife, who is able to provide clear and balanced information , and who is non-judgemental and non-directive can help the parent(s) to make the decision that is right for them. Unfortunately, within the resource limited NHS, it can be hard to find someone with the necessary skills, knowledge and time to take on this role. Your NHS provider may provide you with continuity of midwifery care for routine services, but many women/families want to have a specialist with them as an adviser, supporter and advocate.
If you are unsure about termination, it is important not to rush into a decision which is, by definition, life changing. The decision about termination of pregnancy can be even more difficult when there is limited time available to make a decision. Angie has often met families following their mid pregnancy anomaly scan which has identified a problem or issues of concern. Awareness of the legal time limits for abortion can mean that the pressure to make a decision becomes overwhelming. Making good decisions takes time. A specialist midwife who understands the issues your baby is facing and has counselling skills can help you navigate this path. As an independent midwife, Angie is not constrained by organisation issues such as shifts, standard appointment times and so on. She can meet with you, at a convenient place and at the time you need her. This may be for many hours over a few days.
Although a strong supporter of home birth (2 of her 3 children were born at home), Angie believes that hospital birth is appropriate for babies facing health issues. This is to ensure that any unexpected events can be addressed quickly. This may be a baby needing more help than was expected in making the complicated transition to external life, or a baby who defies very poor predictions and shows that they could potentially benefit from intensive care. Her knowledge of NHS facilities and the specialist skills available at different hospitals enable Angie to help you help you navigate and get the best from the NHS. She can accompany you to hospital appointments and at the birth. More about Angie.
The relationship between parents and a midwife is very special. Walking together through a life changing experience, sharing the experience of becoming a parent, highs and lows, fear and joy, all combine to make this an often intense and very special professional relationship. By taking up the opportunity to have a free initial consultation, you can explore, without obligation, whether Angie is the right person to walk with you. Angie feels very fortunate that she has remained in contact with many of the families she has worked with over the years and holds many very precious memories of babies she has met through this work. Phone now to discuss how Angie could support you.