What is an Independent Midwife? & What do we do?

What Is An Independent Midwife? & What do we do?

Written by Laura Spencer – NMC Registered Midwife – Independent Midwife for Gentle Midwifery Norfolk, August 25th 2025

A very good question!
It’s people like me who are providing maternity care to women and families outside of the NHS. Independent midwives have been around for a very long time, but they are not talked about very much and that’s actually really sad because the difference in care we can provide can be substantial, bringing benefits to not only the women’s physical health but also her emotional wellbeing (You can access more advice on emotional wellbeing in pregnancy herehttps://share.google/4H7Druo)EBihQek15).
A big shift has just hit the Independent Midwifery world, you see I was previously with Private Midwives UK, my first stepping stone after leaving the NHS, but recently due to the current financial climate they have unfortunately become insolvent. This meant many midwives lost their jobs and were left with the decision to return to the NHS which I’m positively sure a small amount if any took that option! Don’t get me wrong the NHS has its place but it is also struggling financially and services are suffering, staffing and retention is dire, waiting lists are getting longer, and now I’m digressing apologies. Some Independent midwives saw this close, as a sign for them to finish in their Midwifery careers which is so sad to hear as we are such resilient, compassionate people wanting the best care for our women and families and we have all worked extremely hard to get that title. The rest of the midwives who didn’t take completely different jobs, found themselves quickly plunged into Independent Midwifery, particularly those who wanted to honour the care for their ongoing clients. I was in the group plunged into Independent Midwifery, it was something I’d thought about but wanted to do maybe 3-5 years down the line. Anyway overnight I became not only a Midwife but a business woman, it felt so odd to mix the 2 as they feel very far apart from each other. So over the first few days I started watching tutorials, paid for masterclasses, and started working through the mountain of things you need to do when setting up in business, safe to say I’m still working through them! So to return to my story, an Independent Midwife can give you the benefit of time, flexibility, is able to travel and can focus solely on you, we can organise your appointments to take place at home at a time to suit you, we can work around your work and childcare commitments and we can do weekends and evenings as well as daytimes. We are easily contactable J and I personally would normally encourage my clients to fully utilise my email, text, call or WhatsApp depending on what works better for them, soI ensure they have multiple avenues of contact for me. I would obviously make them aware that prior to 37 weeks I am contactable only during my office hours which are 9am and 9pm as no one likes to be woken up at 3am to be asked – is it ok to dye my hair? Sounds crazy right! But the pregnancy mind and hormonal changes can cause you’re mind to work differently, questioning every little thing at all hours of the day! (Just on that note, its reasonably ok to dye your hair in pregnancy but for further advice see herehttps://share.google/hBadFIITSCpERBrAI) We all know too that pregnant women struggle to sleep! because they have a little person who wants to be awake at night and do the ‘Kung fu fighting’ dance in their belly! Every Midwife’s availability will be different, and they will have their own life commitments too, so it is important they share that with you from the offset. Independent midwives are very friendly and down to earth, I love nothing more than sitting having a chat and a cup of tea or coffee with my client’s, really spending that time to get to know them and their family, it’s really a privilege to be a part of their story. I give up to 2 hours per appointment J this gives me time to do your health checks and discuss any worries or concerns you may have, and to answer any bubbling questions you can think of. I will sometimes integrate some hypnobirthing ( recommend this audiobook if you feel like Hypnobirthing will be for you, I do incorporate it for free in some of my packages of care –https://www.audible.co.uk/pd/Mindful-Pregnancy-Audiobook/0241491886 or massage into my appointments if you are happy? ultimately, I aim to leave the appointment leaving you and partner calm, reassured, relaxed and in control. At each appointment I will scribble a summary into your maternity notes, this is so I can keep an eye that everything remains the same and within normal limits and it also starts to build a picture of the pregnancy and how the baby is developing. With your consent of course I will conduct some checks at each appointment- your blood pressure, this is to ensure you are not pushing yourself too hard and to make sure the pregnancy isn’t putting too much strain on the body, I could go into these checks in a bit more depth but this would probably bore you! However if you’re the mum who needs to know everything and why? Check out my upcoming blog in September on ‘ How pregnancy affects the body’. I will also be checking your urine, not because I’m obsessed with wee! but because your urine can tell us a lot about your health and your pregnancy, so I would request you to be doing a sample for me for every appointment if your happy? I will measure your tummy with a tape measure to check how your baby is growing and I can plot this on a special grow chart customised just for you and have a visual of your baby’s growth over time. Some people may not need this kind of measuring if they are having regular scans for any reason (if this is the case, please don’t feel anxious, many women need scans for various reasons – you can see more information herehttps://share.google/gaDSEoZPrD8L15JOJ). After this I am going to listen in to your baby’s heart rate with your consent of course (this is from 16 weeks onwards, as it can be difficult to find the heartbeat prior to this due to the baby’s size and position), as part of this check I may also check your pulse, to be sure I am listening to your baby and not your own body’s pulse, when I listen in, you may hear a whooshing sound – this is normal, this is the blood flowing through the cord to the placenta, the baby’s heart rate is more like a drum sound and is usually around double our heart rate (hear it here athttps://youtube.com/shorts/t_6frAnREg?si=o4iTmijMm8T9gX5N)the normal rate is between 110 and 160 beats a minute, so much faster than ours! I will listen for 1 full minute then write down the heart rate in your notes. Depending on your package with me there may be some appointments where I will ask if I can take some blood from you, this could be your booking blood tests, your 28 week blood test, your 34 week iron blood test – see more info on blood tests herehttps://share.google/UWRdEK4j4jhNTI8h8K, the NIPT (a blood test to look for congenital abnormalities in pregnancy) – for more info on this seehttps://share.google/PPVYU40vpLxEWHYor the CFFDNA (a blood test that extracts your baby’s DNA from yours to determine if your baby has a positive or negative blood group – this is only carried out for women whose blood group is rhesus negative). I advise before blood tests to drink plenty and try and have a small meal beforehand (unless I have advised you to fast – which would happen if you were having a Glucose Tolerance Test to look for gestational diabetes ((diabetes in pregnancy)) – you can read more info about this test herehttps://share.google/Uujx3oFqcIMMfw2C4once all of the health tests are complete I will ask about your mood and how your feeling to help assess your emotional wellbeing, this is where some hypnobirthing techniques or massage can be quite beneficial, sometimes the hormonal changes in pregnancy can alter the mood and that’s ok, I will regularly check in, offer support and if needed signpost you to other people who can help. Following this I will open the floor to you, a time to hold space, bring up any worries you may have, and concerns your partner may have, ask any questions you may have and just use that time to chat and ground you with reassurance. At that point I leave you to digest everything, have a chat with your partner/family and am always available (within office hours) to answer any questions after your appointment, you just need to get in touch! These appointments continue until we approach 36 weeks, at that point I find it useful to offer you a session with a Lactation Consultant this gives opportunity to discuss your planned method of feeding, any concerns with feeding, and previous experience and a chance to give you some troubleshooting hints and tips to get you off to the best start, including the collection of colostrum – I have a separate blog coming in September on Colostrum Collection . Following this we will have a Birth Planning session, we will gently explore your preferences, thoughts, feelings and worries. We will talk about what to pack in your hospital bag (even with a homebirth I advise preparing a hospital bag just in case! It’s always better to be prepared!) We will talk about what to expect, pain relief options, complimentary therapies, when to call the midwife, feeding, safe sleeping (At this point I will direct you to the Lullaby Trust –https://www.lullabytrust.org.ukto explore more about keeping baby safe), and how your partner can help. I will give you evidence-based information to help guide you and liaise with other teams regarding your care if required. We will chat through the BRAIN acronym to ensure you feel included in all your care decisions and briefly broach what will happen if we need to go to the hospital and the logistics of this. I will go through a homebirth checklist with you to ensure your home is adequate and prepared and we will talk through setting up the pool (https://www.birthpoolinabox.co.uk)and how to incorporate personal elements into your birthing experience. The next step is to await your birth, I will continue to check in with you weekly up until your baby arrives. You will know from your birth plan discussion when to call me in labour. I will have a conversation with you over the phone to establish where in your labour you are, once I feel assured that you’re in active labour I will make my way to you. Just to note that due to our insurance cover as Midwives we do attend birth as 2’s so another midwife will accompany me, I would ensure that she wasn’t a stranger as I don’t wan’t you to become anxious during your birth so I will ensure you meet the second midwife prior to your birth so that you have had an introduction to each other. We can start thinking about setting up your pool and I will offer to start monitoring your baby with a Doppler, we recommend that you have this check in every 15 minutes in your first stages of labour and then every 5 minutes when your pushing, it gives us a really good picture of how baby is coping with the labour process. I will be encouraging you to eat and drink as normal, drinks like Lucozade can be beneficial at this stage as contractions can tire your body. It may be worth starting with your Tens Machine (These can be rented herehttps://share.google/IA0pzOqnmpHWr5Kt8 or is complimentary to hire if you purchase my Complete Homebirth and Newborn package (https://share.google/xsL6McFwcBOSNp7Ty) and thinking about optimal fetal positioning (getting baby into a good position to deliver), using a birthing ball can be helpful and using a Rebozo (https://share.google/dp8TcfPAzFg0cVMKL)can be supportive and get your partner involved, we can use music, aromatherapy oils, hypnobirthing techniques and low lighting to help set the scene and promote your oxytocin (feel good hormones) level. I will be regularly checking your heart rate, blood pressure, temperature etc. and will discuss with you at any point if I feel worried about anything. I will support your partner to get involved, and to be a part of your birth in every way I can, I’m more than happy for your children or pets to be present. I have a passion for active birthing so if you’re willing, I will encourage you to mobilise in your labour in a variety of ways, it can help with the pain, speed up your labour and make you feel more in control, and its good for getting baby into a good position. Once birth is complete, I will support with feeding, cleaning up and I will guide you how to monitor your baby for after I leave you. After I leave, I will be contactable if you need anything, I will return the following day to check you both over and complete baby’s specialised top to toe check called the NIPE examination (https://share.google/8Dul4Uy2OKygAtz)- a check that focuses on the eyes, heart, hips and testes. Depending on the package you choose I will continue to see you for your allocated postnatal appointments and be contactable in between. If you feel you need more enhanced Postnatal support, I do offer packages to support this or I can add onto the full package to customise your care for you. So there you go! I hope that has explained what an Independent Midwife is and what we do. Essentially, we are in unique position to offer you Personalised bespoke Continuity of Care that just isn’t always available with the NHS due to various pressures, we are happy to work alongside your NHS care and signpost to other professionals if needed. We are part of a large network so when one of us doesn’t have an answer, someone in our community will do, so we have a large resource to revert back to if needed or if we come across something rare or unique. I personally as an Independent Midwife feel very passionate about advocating for women and ensuring they feel heard and involved in their care, I have cared for a vast range of women – VBAC’s – (vaginal birth after Caesarean) Twins, Breech, Same sex couples, IVF, and people experiencing a loss. I am a very calm and gentle person and professional in all the right ways, but I am down to earth, easy to gel with and have my own life experience of having babies and being a patient in the Maternity system. Like many Independent Midwives I have extra strings to my bow – I have a basic level of Spanish language, I have completed Hypnobirthing and Massage training and can offer pregnancy and baby massage with or without aromatherapy oils. Some people struggle with the cost of Independent Midwives and I totally understand this, the cost of living is becoming excessive and we still currently have a free NHS at the point of care so I can understand why people may be directed towards the NHS, all I would say is think about the birth story you would like, do your research on the maternity unit closest to you, ask about the availability of the homebirth team and if they cover your area and most importantly take a look at the evidence and the positive outcomes resulting from Homebirth/ Low risk Midwife led birth – there is evidence that points to reduced levels of intervention, increase in successful breastfeeding rates, less tears, reduction in birth trauma and much more, the evidence speaks for itself. Then chat with your partner and your family, weigh up your options, decide what’s important to you and consider if the cost is a worthwhile investment or not? You don’t need to pay it in one go, I have an instalment plan available and many complimentary services, professionals’ input and products included in my plans which you can’t always get with hospital care.