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

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.