NHS & private maternity care

Care from non-NHS midwives

8 min read

Some women opt to pay for a private or independent midwife. Find out about private maternity care and how it can be paid for.

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If you want more flexibility in your maternity care than the NHS can provide, you might want to look into hiring a private or independent midwife. Read this guide and watch our video to find out why you might consider private maternity care, what the options are and what private care the NHS can sometimes provide.

Why consider private midwifery care?

From more flexible appointment times to having the same midwife for your antenatal and postnatal care, there are several reasons why some women decide to pay for a private midwife.

In this video an independent midwife explains what she believes are the benefits of using a paid-for, non-NHS midwife for maternity care.

In our survey of nearly 2,000 parents who have a child under five, only 2% had opted to pay for a private midwife. Of those who did, the three main reasons for doing so were wanting specialist care or support that wasn’t available on the NHS, wanting to have more flexible appointment times, and wanting to see and get to know the same midwife throughout pregnancy and during labour.

Here are the top three reasons why you might want to consider paying for private midwifery care.

1. If you’re at increased risk of complications

If you’re at greater risk of developing complications, you may want the reassurance of knowing that your midwife has experience with your particular situation. For example, some independent midwives are experienced in helping women with twins or a breech baby, or women who’ve had a previous caesarean, so might be able to give you additional support.

Nearly half of parents in our survey who chose to pay for a private midwife did so because they were at increased risk of complications and wanted a midwife with specific experience. Around a third wanted support that wasn’t available at their local unit, such as for a VBAC (vaginal birth after caesarean).

Not all alternative providers will offer care to women at increased risk of complications, so discuss your options thoroughly with any provider you’re considering.

2. You can get more flexibility

Many alternative midwifery-care providers offer more frequent appointments than you might get from the NHS, and may see you in the evening or at weekends. Appointment times can also be longer, giving you more time to discuss concerns or ask for advice.

We found that two in five parents who paid for a private midwife did so because they wanted to have appointments at more convenient times.

You can also use private care to ‘top up’ NHS care. This means you can receive NHS care, while at the same time having the benefits of your own paid-for midwife, so the paid-for care is supplementing your NHS care. For example, you can still have scans and tests on the NHS, and give birth in an NHS hospital, but can have other antenatal and postnatal care privately, as well as additional paid-for scans such as 3D scans. Some alternative providers offer additional antenatal or postnatal care only before or after your baby is born, not during labour.

3. You’re more likely to get to know your midwife

Midwifery services from private (non NHS) providers usually provide continuity of care. This is where you’re looked after by only one or two midwives throughout your whole pregnancy. This means you’ll be looked after by a midwife you know during labour and birth, as well as for your care before and after the birth.

Depending on where you’re having your baby and the package you’ve paid for, your private midwife will either be your midwife during labour, or may be acting as your birth partner. This continuity of care has both medical and personal benefits, including reduced likelihood of having medical interventions. Find out more about the benefits of knowing your midwife.

In our survey, two-thirds of parents paid for a private midwife either because they wanted to see the same midwife at every appointment as well as during labour, or because they wanted to get to know their midwife.

independent midwife for options and choices

Who can provide me with alternative midwifery care?

There are two main types of non-NHS midwifery care.

  1. Private care is provided by midwives who don’t work for the NHS. You have to pay for their care yourself.
  2. Free NHS-commissioned care is offered by midwives who don’t work for the NHS, but whose services you can use free of charge because they work for an organisation that’s funded by the NHS.

Private midwives and care options – paid for by you

You can pay for private midwifery services, which provide care in addition to your NHS care. If you’re planning to give birth in a private hospital, or are paying for a private obstetrician, you may also be receiving private midwifery care. Outside of private hospital packages, paid-for midwifery care is provided in one of two ways:

  • Midwives who work for a non-NHS organisation and provide care that you pay for. For example, UK Birth Centres are private companies that provide private midwifery care, and Neighbourhood Midwives are social enterprises operating in most London boroughs and parts of Kent, Surrey and Berkshire.
  • Midwives who are self-employed and work alone or in small practices, providing care that’s usually paid for. Independent Midwives UK (IMUK) are a membership organisation for independent, self-employed midwives in the UK.

Private midwives and independent midwives are fully qualified and work outside the NHS. However, they will work with NHS professionals in relation to your pregnancy when necessary. These midwives can often provide antenatal care, as well as look after you during labour and after your baby is born.

Many women who hire private or independent midwives are planning a home birth. If you give birth in an NHS hospital or birth centre, most private or independent midwives won’t be able to be your midwife for the birth, but can come along as a birth partner.

Find the right place to give birth

Discover whether birth in a local labour ward, birth centre or at home would be best for you.

Find your best fit

Is private care available in my local area?

Independent midwives are available in many parts of the country, and there are private hospitals available in and around London. However, the provision of private care varies across the UK.

Use our Birth Choice tool to see what’s available through your local NHS units, or do a search on the IMUK website to find a private midwife in your area.

Do I have to pay for private care?

In most cases you’ll have to pay for private midwifery care, although in a minority of cases NHS trusts pay for this care (see information on NHS Commissioned care, below). The cost will depend on the area you live in and the services you require, and can range from £2,000 to £5,000. Some allow you to pay in instalments, so you should discuss your options with the service you’re thinking of hiring. If you would like continuity of support but are not opting for a private midwife, paying for support from a doula during birth is another option.

NHS-commissioned care – paid for by the NHS

This includes:

  • midwives who work for a non-NHS organisation but provide free NHS care, such as the One to One midwifery service
  • independent midwives who provide free NHS care in certain circumstances.

In some areas, alternative providers are able to provide care that’s paid for by the NHS. The One to One midwifery service is available in some areas of the country. One to One provides free, personalised care that gives you the option of having your own midwife throughout pregnancy, during labour (if a home birth) and for six weeks after your baby is born. If you choose to have your baby in an NHS labour ward or birth centre, your midwife can’t act as your midwife during labour, but can be there as a birth supporter. In Waltham Forest, London, Neighbourhood Midwives are offering a similar type of service as part of a two year pilot.

Contact One to One or Neighbourhood Midwives directly to find out whether they cover your area, and how to book through self referral or your GP.

Some independent midwives and groups of midwives also have arrangements with NHS trusts. If the NHS is not able to provide a particular midwifery service, such as cover for a home birth, or if you need a midwife with specialist skills, for example if you’re having a breech birth, you may be able to have an independent midwife paid for by the local NHS trust. Bear in mind that in most cases your local NHS will be able to provide the services you need.

Is NHS-commissioned care available in my local area?

Use our Birth Choice tool to find out more about your local NHS labour wards and birth centres. Where alternative providers of care are available, this will be highlighted under ‘non-NHS Care’.

Do I have to pay for NHS-commissioned care?

You do not have to pay for this sort of care, because the services of the non-NHS midwives are paid for by the NHS.

Are non-NHS midwives insured to provide care?

Since 17 July 2014, it’s a legal requirement for all healthcare professionals, including midwives, to hold appropriate insurance to be allowed to provide care. NHS midwives will be covered by the agreement that the NHS has in place on behalf of its employees. Private employers of midwives are likely to have professional indemnity arrangements in place for their employees as well.

Self-employed midwives (independent midwives) can be insured through the IMUK professional indemnity insurance scheme, or through a commercial insurance provider. This means that if an independent midwife provides maternity care and your baby experiences a serious medical problem which is proved to be due to your midwife’s negligence, you can make a claim through the midwife’s insurance.

No compensation is payable where the adverse outcome was unavoidable and not related to poor or negligent care, wherever you have your baby and whoever provides your care.

If you want to use the services of an independent midwife, ask them about the insurance arrangements they have in place.

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