Private midwives may be forced out of business next year when changes to the medical insurance rules come into effect.

The Government has given notice that all health practitioners will be required to carry professional indemnity insurance after problems with an underinsured orthodontist.

Private midwives have been without indemnity insurance since 2002, when the last company willing to provide cover pulled out. Despite this, their numbers have grown from about 40 in 2002 to 200 at present, with up to 4,000 babies a year delivered privately.

At the same time the NHS has struggled with an acute shortage of midwives. A government promise of one-to-one care with one midwife and the choice of a home birth has not materialised in many parts of the country.

A recent official report found that 18,000 mothers suffered severe complications during NHS deliveries since 2004. Negligence payouts over NHS deliveries have also soared, with £2 billion worth made since 1995 and half of those made in the past five years.

Annie Francis, spokeswoman for the Independent Midwives’ Association, said: “If the Government decides that private midwives cannot be exempt from this new law, or will not help us to find a company to insure us at a rate that midwives can afford, we will not longer be able to offer care to . . . mothers.”

Independent midwives tell mothers-to-be verbally and in writing at the first meeting that they are not covered for claims. “Most clients understand you can’t insure against things going wrong during childbirth, only against negligence, and negli- gence is not really an issue for us,” she said. The last major lawsuits against private midwives followed the birth in 1994 of two babies with cerebral palsy.

Sian Doyle, 35, who gave birth twice on the NHS before turning private for her last child, said that she had been concerned about the absence of indemnity insurance. “I am a professional negligence lawyer so for me the absence of indemnity went against the grain . . . I decided if something tragic happened, money would not soften the blow. And in any case, I had total trust in my midwife.”

She said that the standard of care she received was far higher than what she got on the NHS, where she was pressured into having her babies induced when ten days overdue. “In terms of midwives, it was totally arbitrary — a case of whoever happens to be around on the day — and in terms of postnatal care, both hospitals were utterly hopeless,” she said.

She is horrified private midwives could soon be driven out of business. “If these dedicated women are robbed of the chance of offering this service it would be terrible. Why take this choice away from women when there is no alternative?”

Ms Francis said that private midwives would like to practise under the umbrella of the NHS. She said: “They are mostly former NHS midwives who have left because of frustrations with the workload and disjointed care they were forced to offer. Many would still like to work in the NHS but feel they cannot practice what they have been trained to do there.”

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