- They can't get professional indemnity insurance because there is no insurance provider that will insure them. No provider has offered insurance since 2002, and even then the premiums ran to over £15,000 per midwife.
- Which is wholly unreasonable, because apparently negligence "isn't really an issue" for independent midwives.
Just in case anyone didn't follow that - negligence isn't really an issue for independent midwives, which is why no insurance provider will insure them. Okay? Okay.
The Independent Midwives Association is pushing for one of two "solutions" to this problem:
- The Government should "ensure that affordable indemnity insurance is made available to all midwives". Of course, they don't say exactly how the Government might go about compelling insurance providers to make insurance available to independent midwives. If anyone can think of a way to do it, do please let me know, because I have been thinking really really really hard when I should have been working and I still just can't think of a way. Apart from the Government indemnifying independent midwives itself, of course. (Don't you DARE, Government. I mean it.)
- Independent midwives should be exempt from any requirement to have professional indemnity insurance in place.
Why is it so important for independent midwives to carry on practising, even without insurance? Because, the IMA says, they provide "woman-centred, autonomous midwifery practice".
(You know, the sort that women had up until the nineteenth century, when women were most likely to die in, or of, childbirth, as I think were babies.)
And why is that so much better than the NHS? Because the NHS is all boring and masculine and unfriendly, with its not-remotely-cuddly "Trust policy and protocols, which are often obstetric-led and therefore focus on the abnormal". Midwives, you see, are "experts in normal birth". Woman-centred, autonomous experts in normal birth. Sounds great, doesn't it? Until you think about what it actually means - which is that if you are at home with your autonomous expert in normal birth and your birth turns out to be scarily abnormal, you might as well have drawn a smile on a sack of potatoes and propped it up next to your birthing pool.
(That's not quite fair. At least an independent midwife can dial 999.)
Okay, I'm losing my temper a bit. I am sure I am being very unfair on independent midwives, who are probably very good at reassuring nervous women and dealing with normal births. I think insured midwives, preferably in hospital, are a very good thing. It's just that if I was giving birth, I wouldn't want the whole thing resting on a woman-centred autonomous midwife who knows how to do a normal birth. Normal birth is, well, normal. In theory you ought to be able to do a normal birth on your own. But you don't, in case it goes wrong. And if it goes wrong, you want someone who knows what to do when it goes wrong. You want an obstetrics-centred doctor who has some idea of how to save your life and your baby. And you also want someone who is insured so that if they fuck up someone will at least pay for you to get the help you need.
Now, independent midwives are obliged to tell their clients that they aren't insured. But I wonder if they tell them why. The reason independent midwives aren't insured is because they are too much of a risk. That's how insurance companies work. They evaluate risks and basically they take an informed bet. Apparently they don't think that midwives are a safe bet. And when you think about what insurance companies will insure, that's pretty scary. They'll insure you to build a house for other people and pay out if it falls on their heads. They'll insure you to operate on people and pay if they end up needing round the clock care for the rest of their lives because you were flirting with the nurse and accidentally removed all of their limbs and half their head. They'll insure you to represent clients in legal proceedings worth tens of millions of pounds. They'll insure an 18 year old boy to get behind the wheel of a VW Golf and pay out when he ploughs over a red light and into a taxi killing three and leaving two brain damaged. And, of course, they will insure doctors and hospitals to preside over births, even abnormal ones, and pay out when they fuck up.
But they won't insure an independent midwife.
If independent midwives can't get insurance, perhaps they should stop being independent and go into the NHS, where they can spread some of that woman-centred love around with proper obstetric support on the next floor down if it all goes wrong halfway through. But whether they continue to be exempt from the requirement to obtain insurance or not, if I ever have children I'm having them in hospital. Even if the paint's peeling and the doctor is unfriendly and they won't let me have a paddling pool. Because if the insurance company won't bet its cash on an independent midwife, I'm not going to be the one who bets my family on them.