The NMC's behaviour here is appalling in so many respects. The immediate implementation of the decision makes it especially damaging. Expectant parents have formed birth plans which depend upon the independent midwives with whom they have built up relationships of trust. To disrupt these plans without extremely good reason is deeply intrusive and unethical. As Birthrights explains in their critical open letter, NMC's actions "appear designed to cause maximum disruption and damage to independent midwives and the women they care for." They continue:
The NMC has a key role to play in protecting public safety, yet this decision directly jeopardises the health and safety of the women it is supposed to safeguard. Beyond the very real physical health implications of this decision, it is causing emotional trauma to women and their families at an intensely vulnerable time. To date, it appears that the NMC has shown no concern for the physical and mental wellbeing of pregnant women who have booked with independent midwives.
At the very least, the NMC should, as Birthrights rightly insists, guarantee "that all women who are currently booked with independent midwives using the IMUK insurance scheme will be able to continue to access their services" and "that the midwives caring for them them will not face disciplinary action for fulfilling their midwifery role".
Aside from the horrifically rushed implementation, the decision itself just doesn't seem remotely reasonable. NMC Chief Executive and Registrar Jackie Smith has responded with the claim that "The NMC absolutely supports a woman’s right to choose how she gives birth and who she has to support her through that birth. But we also have a responsibility to make sure that all women and their babies are provided with a sufficient level of protection should anything go wrong."
In other words: nice as a women's right to choose might be, what's really important is that she can sue for many bucketloads of money (not just a few bucketloads) if anything goes wrong.
Seriously? That's your top priority? This reveals deeply messed-up values.
(It's arguably wrong for the law to require indemnity insurance of independent midwives at all: The costs are of course passed on to clients, and it's not obvious what legitimate interest the state has in forcing expectant parents to pay for such cover. I understand that in previous decades clients of independent midwives could just sign a waiver indicating that they wished to have midwifery care without such indemnity cover in place. I would prefer to still have that option. So I think the law is wrong. But it's especially absurd for the NMC to not just enforce the minimal requirements of the law, but to zealously root out any midwifery care that might occur with large amounts of indemnity cover that just aren't large enough for their liking. It's obscenely paternalistic, and deeply disrespectful of patient autonomy.)
Finally, there are procedural issues surrounding how unfairly the NMC has treated Independent Midwives throughout this whole process. NMC has consistently refused to offer any guidance to IMUK regarding what level of cover they would approve of. Indeed, the NMC's guidance booklet on their own website specifies on p.3 that "We are unable to advise you about the level of cover that you need. We consider that you are in the best position to determine, with your indemnity provider, what level of cover is appropriate for your practice." IMUK did exactly that. Now the NMC is punishing them (and continuing to refuse to explain how exactly IMUK could avoid such punishment). Is that what the rule of law looks like in this country?
In short: The NMC has behaved with reckless disregard for the rights and interests of pregnant women, and their capricious oversight also threatens the livelihoods of independent midwives who have made every good faith effort to comply with their (unclear) demands.
If you share these concerns, please consider taking a minute to let the NMC know -- perhaps citing your support of the Birthrights letter [pdf] and reiterating its thoroughly reasonable demands.
Update: I see that the NMC claims that "Once the final decision was reached by the Registrar, the NMC had to act quickly in the interests of public safety." What a joke. If you're going to take away a woman's midwife right before labour, on grounds of "public safety", it'd better be because the midwife has freaking Zika, not merely because we can't sue her for a large enough sum.