Professional Indemnity Insurance

(Summary at foot of page)

Professional Indemnity Insurance for allied health professionals has been a hot political topic for independent midwives since 1994 when the Royal College of Midwives ceased to provide cover within their membership package. It was made a legal requirement in July 2014, meaning that from that point it became illegal for a midwife without insurance to attend a birth (as a midwife).


Access to affordable and adequate insurance is of course desirable, however that it should be a legal requirement it is a contentious issue, as it may restrict women's ability to have the midwife of her choice attend her birth.

   Since 1994, any insurance that was available became rapidly unaffordable; midwifery has always been grouped together with obstetrics for insurance purposes; midwifery premiums are also adversely affected by pay-outs made by hospitals (payouts being made rather than go through the lengthy process of proving negligence).
Insurers gradually withdrew from the market, and currently the only PII Insurance for intrapartum (birth) care available to independent midwives is limited: via IMUK at a cost which is inevitably passed on to the client, or via a contract with an employer such as UKBirthCentres who will incorporate the cost in their fees.

   For the last ten years independent midwives have explained their lack of insurance and the potential consequences of that to clients, in the context of shared responsibility and a relationship of trust. Women have been happy to book with us in that context. (I have never knowingly had a client not book with me because of the lack of insurance). Families and midwives alike are aware that PII does not in itself make care safe. Good clinical practice, continuity of care, and a good relationship of shared trust and responsibilty does. Sadly, there are inevitably, but rarely, adverse birth outcomes, but these are not necessarily due to clinical negligence (which is what PII covers, if proven). Indemnity insurance does not in itself make birth safer - and arguably causes midwives to practice defensively where they might otherwise be more open to listening to their own or women's feelings.  Indemnity insurance theoretically should cover costs incurred by clinical negligence which causes an adverse clinical outcome (ie potentially long term care for a brain damaged baby). In reality, proving negligence may be problematic, and insurance policies may not cover all that you expect them to. An insurance policy may also make stipulations about, or place limitations on midwives' practice. For those of us working outside the NHS, we frequently do so because we support women to make choices about their bodies and their births that are not necessarily the norm within that system. Stipulations about our practice may erode that luxury.

I am happy for you to contact me to discuss PII further. It is a complex issue, and it is important that you understand what it means for you, and what any current developments may be.

In Summary

As an independent midwife with Royal College of Nurses membership, I have insurance through the college to do antenatal and postnatal care. You can therefore book these with me directly - including full care, or one-off consultations.
I have a contract with UKBirthCentres, so if you require birth care from me, then it needs to be booked through them. Details of their PII cover can be accessed on their website.
I also work with doulas to provide a full package of independent care (which you may choose to book alongside an arrangement with the NHS to attend your birth). Doulas are not health professionals and do not attend births in any clinical capacity and therefore do not require PII.

If you are choosing to free-birth I can offer antenatal/postnatal care if required, and will offer sources of information and evidence on the subjects of making birth as safe as possible, and discussion of risk and risk perception.