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October 16, 2008 Est 1999 Scotland's award-winning independent newspaper
This life: Allison Ewing is one of six independent midwIves in Scotland now threatened by new legislation. Although fighting her corner, there’s the small matter of helping new life to flourish in the meantime

"MY DAY begins when I get up about 7.30am and I start work at my computer. My husband Alasdair gets up first, then my eldest son Calum, and then I get up. We have breakfast together. My youngest Fergus gets up later and he fends for himself. By 9am, when boys are at school, I start answering emails.

My first appointment is normally at 10am, depending on where the client lives. We spend the majority of time discussing the woman's fears because they have questions about the practicalities of a home birth and how to cope with labour. For a pregnant woman the fear of the unknown is hardest to deal with and they need somebody to talk to.

Most antenatal examinations last 10 minutes - to test urine, blood-pressure and feel the abdomen to find which way the baby is facing. But the fact is everybody's different; some people are more emotional than others so deal with birth differently. My appointments usually last 45 minutes.

I am one of just six independent midwives in Scotland and I will have approximately 11 clients this year, at a charge of £2500. I have been living and breathing the campaign to save independent midwifery for the past four weeks. The government is intending to make Professional Indemnity Insurance compulsory, but as this is not available to independent midwives it will mean the end of our ability to practise.

Yet this kind of continuity of care has been proven to reduce caesarean section rates, lessen the need for pain relief and provide higher satisfaction rates.

I know we are viewed by some senior midwives as mavericks, but we are under more scrutiny than your average NHS midwife.

I'll never say never to anything; I've been to a complementary therapist with clients, but will use ibuprofen and calpol, too. I don't believe births are a mechanical event. The birth process also has an emotional and spiritual aspect to it; a mother is giving birth to a whole new aspect of herself.

It gets up some professional noses that we are there as a servant to women. But I'm aware I have my professional role too; it's a mutual respect thing. I get photographs of children I have delivered, in their first school uniform and sometimes years later there is still a connection.

But I've had hurdles to overcome. For example, the insurance issue and charging for my services. Because I'm a good Scottish socialist, the thought of having to charge for something I think should be free for all women sticks in my craw. I value my service, yet think what we offer should be available to all women.

The benefits of an independent midwife is that we have the luxury of time; I work on a relationship of trust and honesty, which is what counts in the end. But I don't think I'm better than an NHS midwife.

I qualified in 1988 spending a year in a London hospital and then seven years as a community midwife.

We moved back to Glasgow after having our first child and my goal was to become independent because I knew there was no such thing as team midwifery' here.

To be an independent midwife with children you must have bomb-proof childcare and a very tolerant partner. I have a family-friendly approach, so during the holidays, if the clients are willing, the boys can come to antenatal appointments. Calum said he's proud of me being an independent midwife. A happy mum makes for a happy family because I love what I do.

Obviously, for births I can get called out at any hour and they can last any amount of time. I usually have a few appointments a day and two days a week the boys are in after-school care so I can go further afield. But other days I have to be back about 3pm for Fergus and have to manage my job with our activities of choir, violin, cubs and scouts.

My husband has only ever known me as a midwife, but the kids have to be very understanding about my busy life. But we make a point of always trying to sit round the table on a Sunday for dinner.

I don't usually get the chance to watch television until after 9pm, but when I do my favourite programme is Battlestar Galactica. I'm a big science fiction fan and I met my husband at a convention. I used to think getting to bed by midnight was early although now I make sure I'm there by 11.30pm. I suppose the only time I actually switch off is when I go away, but it is my personal belief that midwifery isn't just a job.

I think it is a calling; I believe there are midwives and then there are people who do midwifery."

INTERVIEW: KIRSTY ROARTY PORTRAIT: IAN MACNICOL For more information on the campaign, check out the website www.saveindependentmidwifery.org

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Posted by: fraser kelly, singapore on 5:26am Sun 6 May 07
nice article.
not sure the sentiment expressed as the word servant, wouldnt be more accurate as the word facillitator or advocate.
clearly allison wouldnt do what the mum to be wants, if that thing were dangerous -she would also try to tailor the service to the desires of the mum,with the NEEDS of the mum and the child as paramount.
know what she means though.
I qualified the year before alison as a midwife,and although I dont practice now,I share her philosophy of care, and her experiences of the service in scotland.
I also share her reserves over having to offer a service outside the nhs.
I dont work in the nhs now-in fact i work overseas.
The nhs is a centrilised socialised medicine system, that doesnt allow choice nor inovation.
its not the only way to make healthcare available to all members of society, free at the point of charge.
and free at the point of charge is a bit of a lie,when all it means is you pay at another point-ie in taxes.
If folk had access to their personal tax raised ,to use for their healthcare as they wished-then services like allisons would be widely available to all.
Posted by: Jane Houston, gainesville, florida on 1:47am Mon 7 May 07
Dear Allison,
Good luck in your fight, hope you continue to practise midwifery.
I qualified in 1992 in Glasgow and work in private practice in Florida. The malpractice situation here is untenable and our doctors and midwives practice will be giving it up in August 2007 to make alternative arrangements. Although it appears that certified midwives may HAVE to continue to carry this insurance.
Just another way of further medicalizing birth!
Unlike the other correspondent I long for socailized healthcare. Private care leads to far too much inequity.
Posted by: Shona, Glasgow on 9:03am Tue 8 May 07
Allison was my midwife at the delivery of my little girl at home last year. She made it a trully magical, calm and uplifting experience. I cannot emphasise enough how having one midwife throughout my antenatal care and through my whole (long) labour helped me and my husband to ge the most out of the experience. I am planning to go back to her for my next pregnancy and will be devastated if this wonderful service is no longer available for bureaucratic reasons. Join the campaign!
Posted by: Nicky Grace, Nottngham, England on 11:49pm Tue 8 May 07
Like Allison I am an Independent Midwife although practising in England. I love the article and thought that it was beautifully phrased. It is quite difficult to articulate the situation for independent midwives - like Allison, I have uncomfortable moments at being in private practice - but I simply could not offer one-to-one care within the NHS system and felt I was failing women. This way, I am not living in the problem, I am living in the solution, giving one-to-one care that the women and families tell me they love and appreciate. Like Allison, I love working in this way. Hopefully it will be made available to all women one day, but the only way that will happen is if we are able to sort out this insurance issue and continue to practice. Thanks to the Allison and the Sunday Herald for such a great article! Nicky Grace
Posted by: Joanna Wade, Portsmouth on 11:39pm Wed 9 May 07
Allison delivered our 2nd baby in 2003, at home in water. Her comment that the relationship is "a mutual respect thing" is so true. We totally trusted her and knew that she had mine and the baby's best interests at heart. I knew that if she said I needed to go into hospital, then i did - there was no 'politics' or 'fear of being sued' coming into the decision. She knew us well and what we wanted. She also made great friends with our first child and this was an added bonus. When Allison walked into the room when i was in labour i immediately felt calm and in the best hands possible. When we booked Allison, we understood she had no insurance and that was not even an issue for us. To take this choice away from women would be so detrimental and i know will encourage more women to give birth unassisted rather than within a system where they don't always feel supported and get the care they need. Please visit the campaign website and sign the petition.
Posted by: Robby, south lanarkshire on 6:01pm Wed 31 Oct 07
I don’t really know how to start this, we lost our baby recently and we feel we were let down by the NHS, we are currently seeking legal advice, however we have more or less been told it will be difficult to find a senior qualified midwife who can independently review our case fairly and issue comments on how we should have been handled, I know this is a very delicate matter but we feel if a professional person makes mistakes then it should be exposed, I would be willing to issue more information but in confidence any person who thinks they can assist us please advise.
Posted by: Brenda Newport cpm, Canton, Ohio, USA on 5:58am Tue 5 Feb 08
Allison, I am a cpm (certified professional midwife) doing home births independantly here in Ohio. We are legal here, but not regulated. That means whenever the doc's get an inkling, they try to go after one of us. In 24 states the cpm is used as the standard for lic'ing. We have legislation hoping to introduce to lic us here in Ohio.
Although I was born in the states, I have lots of family in Edinburgh. I was there visiting this past June and hoped to meet some midwives there. UNfortunately, that didn't happen. I wish you the best. If you're interested in an e-mail buddy, let me know.
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