What are the differences between an NHS midwife and an Independent Midwife?

The obvious difference is number, there are approximately 22,000 midwives registered to work in the UK and of those only approximately 50 work independently. The numbers of independent midwives has unfortunately fallen due to difficulties accessing insurance. Those of us remaining, do so because we love our work and consider it a profession worth fighting for. The majority of independent midwives practice in London where most of the demand is. London has many large teaching hospitals but, as there is a general shortage of midwives, sometimes care levels are compromised during busy periods.

All Midwives, whether NHS or private will have had at least three years of training in the NHS before qualifying and all are regulated by the Nursing and Midwifery Council. This involves being able to prove that they have completed enough training including annual updates on practising safely in emergency procedures; such as resuscitating babies or dealing with heavy bleeding. They also have to work enough hours as a midwife and follow various codes of practice. All midwives have a pin number and it is possible to check any midwife’s credentials on the Nursing Midwifery Council register.

Some independent midwives start private practice straight from qualifying but many like ourselves at Sage Femme have considerable experience of working in the NHS first. When we are looking after our clients in hospital we are working as a team with NHS colleagues to provide those clients with the best possible care. This is easier if we have full understanding of the pressures that NHS midwives have to work under. We also understand more about the structures and routines in hospital. This makes us more useful to clients trying to navigate the system during their maternity care.

Independent Midwives will all have a particular passion for normalising birth and reducing unnecessary interventions whilst some NHS midwives will have a particular interest in specialities that involve providing care to women with high risk medical conditions. Their role will be similar to a nurse working in intensive care and they may thrive on the stress and drama of their work. Independent midwives have chosen to lead a quieter life without the drama because they enjoy being with women and empowering them to give birth in stress free environments. Obviously both types of midwives are valuable and should be able to compliment each other using their different skill sets.

Some NHS midwives are horrified at the thought of caring for women having a home birth whilst many independent midwives are equally horrified at the idea of working in a noisy and very busy Labour Ward. Thank goodness we are not all the same.

As independent midwives we have the luxury of providing continuity of care. This is extremely unlikely for NHS midwives working in busy city hospitals. Most women having entirely NHS care will not see the same midwife more than once. We know from much research that continuity of care improves outcomes for women and babies but it also makes our job as a midwife much more enjoyable. After all, who wouldn’t prefer a happy midwife supporting them in their birth journey?

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