The NHS is trying to extinguish an alternative to its own appalling childbirth service

Independent but highly qualified and very experienced midwives face extinction over the issue of professional indemnity insurance. If no help is offered by the NHS to contract in self-employed midwives under the clinical negligence scheme, they will be forced to stop practising by 2009

I am a mother of three who managed, after a protracted fight with the NHS, to have a wonderful, inspiring, uplifting birth with a private independent midwife at home. I am not a nutter. I made more than 100 phone calls in the two weeks between hospital appointments to find someone who would listen to my reluctance to go under the NHS knife, to find someone who would take me on to birth my twins normally. I knew that I could do it, but I didn't really want to fork out £2,000 for the privilege. My mother had birthed my twin brother and me normally, so why couldn't I be encouraged to do the same? After all the puffing and panting, I discovered a secret that too few mothers are let in on: birth can be great. Not an ordeal to be got through, but a powerful beginning to motherhood, a set-up for all the snot, sweat and tears to follow. Every woman in this country deserves what I had. Our mothers had it, so why shouldn't we?

Choice: that awful overused government word. The only phrase I hate more in matters of state is “informed choice”. It doesn't mean a thing. Pregnant women don't have any choice. That baby is going to come out one way or another whether they like it or not. Childbirth is a bloody, messy, unpredictable, painful experience that transforms women from selfish girls-about-town into all-important mother figures. Go ask any therapist. So why, in this modern age of feisty female CEOs, are women being dazzled by the flashing lights and deafened by the beeping monitors into believing that they have “choices” when they waddle in the hospital labour ward (if it is actually open for business)?

And why are so many of the good, experienced midwives who understand that women need kindness and encouragement above all in labour getting the hell out of hospitals? And why are these last guardians of normal birth, self-employed independent midwives, being hounded by the NHS in medieval witch hunts to put them out of business?

Has the maternity profession missed something here? Are they really so busy arguing over money, power and control that they fail to notice the labouring woman in the corner, not waving but drowning in her birth pool?

OK, let's put the weapons down for a moment. No woman is going to be challenged here for wanting to wail at the moon on her birth ball, electing for the clinical certainty of a Caesarean or wanting more drugs than Amy Winehouse on the night before a prison visit. Let's accept that all women are different and like to do things their own way, and wouldn't choose the same pair of shoes on the high street or Babygro at Mothercare. Let's focus instead on how all women are the same, have the same creature needs at this worry-filled time, and how those needs are not being met.

First, the Government is saying all the right things. Since 1993 and the first well-worded document Changing Childbirth, successive governments have made confident noises to reassure women that they are going to be looked after properly. The latest 2005 White Paper says even more of the right things, namely that all women will be looked after by “a midwife they know before and after the birth”. Ann Keen, a Department of Health Minister, says: “This will be in place by 2009.” So much for the theory.

Now for the brutal, bloody truth. This one-to-one care is to be achieved by 2009, says the Department of Health, by recruiting 1,000 midwives. But that's not enough, say the Royal Colleges of Midwives and Obstetricians in their report, Safer Childbirth. We need a further 5,000 midwives just to offer one-to-one care in established labour - that's just the pushing stage, let alone the pregnancy and post-birth period. So while the numbers don't add up, paying for these midwives is even more disastrous. According to Louise Silverton from the Royal College of Midwives, the extra 330 million pounds funding announced with a fanfare in January has not been ringfenced, so as the money has started to trickle through last month, reports are already coming back that it's being spent on other wards by the local hospitals.

And how did we get to this stage where dangerously few midwives are looking after far too many women, as many as five in labour at the same time? Christine Beasley, the Chief Nursing Officer, puts the shortage down to the rising birth rate: “The Office of National Statistics suggested that this was a blip at first, but it is now clear that the rising birth rate is an established trend,” she explains. “And the midwifery workforce is ageing. It was part of the baby-boomer population - and many midwives are now approaching retirement. We are recruiting younger people in a more competitive world.”

And at this moment of crisis, when the burnt-out hospital midwives are routinely handling around 170 births each a year in a revolving door of hospital anonymity, the Government chooses to turn on the very last resort left to women such as myself - the independent midwife. These midwives have often been driven out of the NHS because they can no longer practise what they see as safe, women-focused care in the context of a hospital. Many of them are among the most skilful practioners of normal birth in this country - my midwife, Mary Cronk, had assisted at hundreds of successful normal twin births over her 50-odd years on call and tours the country lecturing on normal breech birth. Their possible extinction over an insurance issue that could so easily be solved by contracting them into the NHS as they are in New Zealand, or by just dropping it as a mandatory practice, is a frightening possibility. If the issue is not solved by 2009, all that they symbolise as the “gold standard” of care in this country will be gone with them. As Louise Silverton says: “The NHS should be able to offer this to independent midwives. It shouldn't be a gold standard. It should be every woman's right.”

Make no mistake, this is not just a middle-class fuss. In speaking to dozens of women who have suffered in silence over their recent treatment in hospital, we are all in the same dirty boat. One 19-year-old mother was taken on free of charge by Virginia Howes, an independent midwife in Canterbury, when it became clear that she had been told nothing at all about pregnancy or birth. The girl saw the difference between her own quick labour in a pool at home (“I felt safe and looked after”) and her sister's birth in hospital five months later (“It felt manic and busy all the time, she didn't cope well with it”). While the 19-year-old went on to breast-feed her baby for six weeks, her sister was ejected the next day, with a bottle given for the baby. She never breast-fed and suffered depression.

Post-natal depression, sometimes triggered by a bad birth experience, is rife. Ruth Weston, 39, who lives on a council estate in Bradford, West Yorkshire, forked out 15 per cent of her annual income for an independent midwife for her fifth child, after the trauma of her fourth. “With my first child I got a lot of care on the NHS, and, ten years on, I'm paying for it, and that's wrong. My five births can chart the deterioration of the service.”

As a student of liberation theology, she believes that the only way forward is for midwives and mothers to join forces, and she lobbies her MP and sends postcards to the local hospital to make her feelings known. “Abortion was legalised over a health issue. This is not a moral issue - a small number of women will go ahead and have their babies their way if independent midwives are lost. It's not acceptable, and it's not fair.” And that small number of women is already increasing as they opt out of the NHS altogether in favour of “freebirthing”. Veronica Robinson, editor of The Mother magazine, who lives in Cumbria, is writing a book on the subject, partly in answer to the number of inquiries that she fields from readers. “These women have educated themselves and are not irresponsible as people suggest,” says Veronica. “I think a lot more women will turn to unassisted birth.” Many of these radical freebirthers are often midwives themselves, she says.

However we fight the good fight, we must not sleepwalk into the nightmare of birth in America. In a country where one in three births is Caesarean and only 8 per cent of women are able to use midwives, 18-year-old girls are said to describe birth as like “having more plastic surgery”. Through the film The Business of Being Born, made with chat-show host Ricki Lake, however, that culture is now changing. The US campaign - The Big Push For Midwives - is being used for the Save the Independent Midwife Campaign here in the UK and the movie is being screened all around the country. “On the internet they have already said, ‘Ricki Lake gives birth naked... Ew, I want to vomit',” said Ricki Lake at the premiere. Popcorn, anyone?

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