“I trust the evidence”: Why Australian midwives practice homebirth without professional indemnity insurance

Jennifer Mitchell; Carolyn Hastie; Roslyn Donnellan-Fernandez; Laura Gabriel

doi:10.1016/j.wombi.2025.102159

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“I trust the evidence”: Why Australian midwives practice homebirth without professional indemnity insurance

Journal article

Open access

Peer reviewed

“I trust the evidence”: Why Australian midwives practice homebirth without professional indemnity insurance

Jennifer Mitchell, Carolyn Hastie, Roslyn Donnellan-Fernandez and Laura Gabriel

Women and Birth, Vol.39(1), pp.1-7

2026

DOI: https://doi.org/10.1016/j.wombi.2025.102159

PMID: 41478101

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Abstract

Homebirth

Insurance

Interpretative Phenomenological Analysis

Midwives

Private Practice

Risk

Background Professional indemnity insurance (PII) has not been available for intrapartum care at home for privately practice midwives (PPMs) in Australia since 2001. Aims To examine the effect of the lack of professional indemnity insurance on the private practice of Australian homebirth midwives. Methods In this qualitative study, semi-structured interviews were conducted with midwives (n = 11), who were currently or had recently been providing homebirth services. Interpretative phenomenological analysis was used to explore how midwives navigate professional and personal risk in their practice. Findings Three higher-order themes were found that describe how midwives manage their private practice without PII for homebirth: I feel vulnerable without insurance, The system doesn’t support my practice, and I have my own risk management processes. Conclusion From 2001–30 th June 2025, Australian PPMs provided homebirth services without any PII, putting them at personal and professional risk. Australian PPMs navigate other risks such as the experience of horizontal violence upon transfer from home to hospital, blame culture in the maternity system which may result in an Ahpra notification and ethical distress when trying to provide care for women with complex needs. This research illustrates how PPMs practice in a system that doesn’t support them.

Details

Title: “I trust the evidence”: Why Australian midwives practice homebirth without professional indemnity insurance
Authors: Jennifer Mitchell (Corresponding Author) - Griffith University
Carolyn Hastie (Author) - Griffith University
Roslyn Donnellan-Fernandez (Author) - Griffith University
Laura Gabriel (Author) - University of the Sunshine Coast, Queensland, School of Health - Midwifery
Publication details: Women and Birth, Vol.39(1), pp.1-7
Publisher: Elsevier BV
Date published: 2026
DOI: 10.1016/j.wombi.2025.102159
ISSN: 1878-1799
PMID: 41478101
Copyright note: © 2025 The Authors. Published by Elsevier Ltd on behalf of Australian College of Midwives. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Grant note: This project was completed as part of a master’s dissertation and did not receive any financial assistance.
Organisation Unit: School of Health - Midwifery
Language: English
Record Identifier: 991197251002621
Output Type: Journal article

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Collaboration types: Domestic collaboration
Web Of Science research areas: Nursing; Obstetrics & Gynecology

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