How to Start an Independent Midwifery Business in the UK

Independent midwifery offers the opportunity to provide personalised, continuity-of-care midwifery outside the NHS. It is a highly regulated field with specific insurance and registration requirements. This guide covers the practical steps to get your independent practice set up.

NMC Registration

You must be registered with the Nursing and Midwifery Council (NMC) to practise as a midwife in the UK. Annual registration costs around £120. You must complete revalidation every three years, demonstrating continuing competence through practice hours, CPD, and reflection.

Professional Indemnity Insurance

Since 2014, it has been a legal requirement for all practising midwives to have professional indemnity insurance or an equivalent arrangement. For independent midwives, obtaining insurance for intrapartum (labour and birth) care has historically been challenging and expensive.

Options include:

• IMUK (Independent Midwives UK) group insurance scheme — the primary route for independent midwives
• Individual policies from specialist medical insurers

Insurance costs for independent midwives can be significant — £5,000–£15,000+ per year depending on the scope of your practice. This is your largest business cost and must be factored into your pricing.

Some independent midwives limit their practice to antenatal and postnatal care only, which reduces insurance costs.

Sole Trader or Limited Company?

Most independent midwives operate as sole traders. The income levels and business structure suit sole trader status well. A limited company may be considered if you grow into a group practice.

Registering with HMRC

Register for Self Assessment within three months. VAT: midwifery services are exempt from VAT as a healthcare profession. You do not charge VAT but cannot reclaim it on expenses.

Claimable Expenses

• Professional indemnity insurance — your largest deductible expense
• NMC registration fees
• Professional memberships — Royal College of Midwives, IMUK
• Equipment — Pinard stethoscopes, Doppler devices, blood pressure monitors, scales, resuscitation equipment
• Consumables — gloves, gauze, birth pool liners
• Travel — to client homes, at 45p per mile (independent midwives travel extensively)
• Home office costs — for admin and client record-keeping
• Training and CPD — mandatory CPD, emergency skills updates, conferences
• Phone — essential for on-call availability
• Clinical waste disposal
• Record-keeping systems — clinical notes, digital record systems
• Insurance — public liability in addition to professional indemnity
• Accountancy fees

Accounted tracks all your expenses and keeps them organised for your tax return.

Pricing

Independent midwifery packages vary by scope:

• Full antenatal, birth, and postnatal care — £3,000–£6,000+
• Antenatal and postnatal only — £1,500–£3,000
• Postnatal support only — £500–£1,500
• Birth preparation/antenatal education — £200–£500

Most independent midwives offer package pricing with payment plans.

Industry-Specific Tax Considerations

VAT Exemption

Midwifery services are exempt from VAT. This simplifies your pricing but means you cannot reclaim VAT on equipment, insurance, or other expenses.

On-Call Costs

The on-call nature of midwifery means you may incur significant travel costs at unsociable hours. All business-related travel is deductible at 45p per mile for the first 10,000 miles, then 25p.

Clinical Governance

While not directly a tax matter, maintaining proper clinical governance, supervision arrangements, and record-keeping is essential. The costs of supervision and peer review are deductible business expenses.

Building Your Practice

• Your reputation — word of mouth from satisfied clients
• Local parenting groups — NCT groups, breastfeeding cafés, pregnancy yoga classes
• Online presence — website with clear information about your services and philosophy
• Social media — Instagram and Facebook for sharing (anonymised) birth stories and information
• Doula networks — doulas can refer clients who want independent midwifery care
• Antenatal classes — offering your own classes builds relationships

Bookkeeping Tips

• Separate business and personal finances
• Track mileage meticulously — you will travel a lot
• Record insurance payments — your biggest expense
• Keep records of all equipment purchases
• Set aside money for tax — even though your insurance costs reduce your profit significantly

Accounted connects to your bank and categorises your transactions with AI.

Key Deadlines

• 31 January — Self Assessment and payment
• 31 July — second payment on account
• Every 3 years — NMC revalidation

Getting Started

Independent midwifery is demanding but deeply rewarding. Ensure your insurance is in place, your NMC registration is current, and your finances are properly managed from the start.

Ready to organise your midwifery practice finances? Sign up for Accounted and let Penny handle the bookkeeping while you focus on caring for families.