Independent Midwifery Care

Released on 15/06/2009

INDEPENDENT MIDWIFERY CARE

Background

Today the British Medical Journal published research comparing care provided by independent midwives with maternity care within the NHS. The research found that women who used an independent midwife were more likely to start labour spontaneously, have an unassisted vaginal birth, use fewer pain relieving drugs and were much more likely to establish breastfeeding. 

For women with a straightforward pregnancy, the stillbirth and neonatal death rate was similar to that for women having their baby with NHS care. However, there appeared to be more baby deaths among women who had a more complex pregnancy with an independent midwife.  

Unfortunately the methodology used was unable to compare accurately the women having care with an independent midwife with those using NHS services. Although the sample was matched in terms of age, previous children, year of birth and socioeconomic status there are likely to be many other ways in which the two groups differ, including different beliefs and preferences, making it difficult to make meaningful comparisons.  

Quote

Mary Newburn, Head of Research and Information, NCT, says;

“More than anything else, this research serves to highlight the limited options available to women within the NHS. Independent midwives offer supportive care to each woman they book, lasting throughout pregnancy, birth and the postnatal period. This can be hard to come by in the NHS - though there are some excellent examples of caseload midwifery care in small scattered pockets from Lancashire in the North to Southampton in the South.  

“For women with a complex pregnancy, the trade off of going to an independent midwife to find personalised care, may be having to have a home birth - whether or not this is most appropriate. The NCT backs the Independent Midwives Association call to have access to NHS hospitals so that woman can make informed choices and not have to compromise one priority in order to meet another. 

“There are some significant methodological limitations in this study. Matched studies using different databases are not able to reliably compare ‘like with like’. As a result, the statistical tests which imply scientific rigor may be misleading. We note that the authors of the editorial in the same issue said that this attempt to compare perinatal deaths was ‘hazardously speculative’. “ 

ENDS 

For further press information contact NCT Press Office or email press@nct.org.uk