Independent Midwives – unnecessary indulgence or an unparalleled investment in Motherhood?

Many women wonder why they would pay for midwifery care when they can get it for free in the UK, but with the NHS becoming increasingly overstretched and the disappointing demise in caseloading midwifery (where you have a named midwife throughout your pregnancy), lots of women now never see the same midwife twice, with it being even more unlikely that they’ll have ever met the midwife supporting them in labour. We know that birth outcomes are improved when a woman births in a place she knows with people she knows, as her labour inevitably progresses more comfortably and efficiently when she feels safe and nurtured by people she trusts. A big part of that trust is formed when a woman gets to know her midwife over the course of her pregnancy, as it means she’s receiving care and advice informed by personal experience rather than protocol.

Now I know what you’re thinking, £3k+ is a lot of money, but it’s important to put things in perspective. I think culturally we neglect to respect the life-changing experience a woman goes through when she becomes a mother. We think of birth as a somewhat mechanical process, a One Born Every Minute style conveyor belt of stereotypes and surgical assistance, where each woman is merely a user of the service. More and more women I encounter though are questioning this, and realising that a big part of the journey towards a positive birth is in making informed choices, feeling looked after, and empowering themselves to create the birth they want, just like they do in every other aspect of their lives. With that in mind, I personally consider finding the right midwife for you an investment in one of life’s most monumental moments. A positive, empowering birth sets a woman up for a confident transition into motherhood, something I wholeheartedly believe is invaluable.

Just before Christmas I met with the wonderful Annie Francis, CEO of Neighbourhood Midwives – the only employee-owned midwifery social enterprise providing fully insured care in and around London. Annie has looked after a number of women that I’ve taught, and hearing first-hand how much her and her colleagues enriched my clients’ births and complemented their hypnobirthing preparation, I am keen to help spread the word of such a valuable service.  Hopefully Annie and I can iron out some misconceptions along the way, and offer some clarity on a service that more and more women are enlisting as they strive for a better start to motherhood.

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What is an independent midwife, and how does this differ from the midwifery services I would receive via the NHS?
As independent or private midwives, we are qualified and registered in the same way as any other midwife but we have chosen to work outside of the NHS in order to provide continuity of care. This means that you can meet one of us for a free consultation and decide if you ‘click’ first and then, if you choose to go ahead, you can directly engage our services to provide your care on a one-to-one basis. You can either ‘top up’ the care you receive through the NHS or we can provide all of your midwifery care from booking, through the pregnancy, birth and postnatal period. We do all our visits at your home at times to suit you and can get to know the whole family.

We are on call 24/7 to deal with major worries (or even little ones) and will come to your home when labour starts. We remain with you until the baby is born and everyone is settled, whether you choose to be in hospital or at home and afterwards we will visit daily at first, then at intervals until we discharge you, generally 6 weeks after the birth.

The NHS provides excellent care but this is often from a different midwife at every appointment and so can be very impersonal. Some women in London have reported seeing up to 9 different midwives antenatally, none of whom will look after her in labour. Continuity of carer is currently not usually available to most women on the NHS and yet we know that having a relationship with your midwife is really important to women and generally leads to safer outcomes for both you and your baby.

What are the benefits of hiring an independent midwife?
Complete peace of mind, through continuity with a midwife you get to know and trust;
Access 24/7 by phone or email; and
The reassurance of knowing a trusted professional will be by your side throughout. The evidence shows that this type of care leads to better outcomes for mum and baby, both in the short term and long term.

If I have an independent midwife, do I have to have a home birth?
Absolutely not. You may know you want a home birth right from the start or you may not make a final decision until much nearer the time, while others prefer to have a planned hospital birth but with the reassurance of their own midwife by their side.

“Along with hypnobirthing, Neighbourhood Midwives is the best money we’ve ever spent – worth every penny and more! The service is second to none and the continuity of care pre and postnatally has been invaluable. We have no doubt my labour would’ve been a very different experience for both me and Pete had it not been for Annie’s presence – we can’t recommend Annie and Neighbourhood Midwives highly enough.” – Vanessa & Pete

How much does it cost, and what if I can’t afford to pay upfront?
Our costs vary from £3000 to £5000 for full care in and around London. Neighbourhood Midwives want to be available to as many women as possible so we offer a range of different packages and the option of payments through installments are always available. One dad said afterwards that it was better value than his beloved Vespa!

How will having an independent midwife benefit me pre and post birth?
During the antenatal period it is very normal for you to have lots of questions and worries. Normally you have to save these up for many weeks before you next see your midwife but with an Neighbourhood Midwife you can just text anytime.

You never have to go through the same information twice because, as your midwife, we get to know you well and can work with you to resolve any problems, identify what your concerns are and then act accordingly to reassure or organise further support where necessary.

We can accompany you to any specialist appointments to help you to understand all the information you are being given and what the options are as a result. We can help access the best therapists for you and advise on a variety of classes and activities, in short we can help you and your partner feel as prepared as possible for this special event.

After your baby is born, we will visit you every day to begin with – sitting by your side and listening, offering guidance, advice and support. All our midwives are highly skilled at breastfeeding and can usually help to iron out any problems, guiding you to make your own decisions and to grow in confidence as a mother. Over those early weeks, we will continue to visit and are always available by phone, helping with any issues that arise and ensuring your recovery and the wellbeing of your baby. By the time we say goodbye you will generally be fully recovered and thoroughly enjoying your baby and your new life as a mother.

“Enlisting the services of Neighbourhood Midwives is without doubt some of the best money I have ever spent. I didn’t appreciate it at the time, but I didn’t just pay for a one off service or even a few weeks’ worth of service.  Amber is 6 weeks old now and I am still feeling the benefits.  I am sure I will feel them for a long time to come.  I recovered quickly both physically and emotionally and look back on my birth with pride and very fond memories. Having midwives who knew me and who I trusted entirely, helped me to have the birth I always hoped for, one without panic or fear. Annie and Tina are not just incredibly experienced, professional midwives they are lovely, wise women who are worth their weight in gold.” – Debbie (read her full and beautiful birth story here)

IMG_16772Finally Annie, why did you decide to become an independent midwife, and how did Neighbourhood Midwives start out?
I did my training after I had all four of my children, largely inspired by the amazing births I experienced and my independent midwife, Caroline Flint. I qualified in 1998, all set to be part of the brave new world of maternity services which I thought was coming with Changing Childbirth. Sadly it didn’t materialise that time around and, because I had experienced for myself the enormous value of having continuity of care it was the only way I wanted to practice and so I became an independent midwife and worked that way for 17 wonderful years.

For the past ten years or so, we were also working on trying to solve the insurance issue and eventually, after many false starts, we found the right vehicle in employee ownership (just like John Lewis). For eighteen months we worked closely with our social investors setting up all the necessary structures and governance to successfully access full indemnity insurance. Then, in July 2013, we launched Neighbourhood Midwives, a social enterprise with a mission to eventually be commissioned by the NHS. In the meantime though we offer a private service across London, building our track record and doing what we love best, providing safe, high quality continuity of midwifery care to women and their families.


Neighbourhood Midwives are currently running a promotion offering all families who book a full care package with them before 31 January a stocking full of gifts from Aden & Anais, Pinter and Martin and Nom Nom.