Blame 'not answer in baby's death'

21:38, Feb 17 2009

People need to stop looking for someone to blame for the death of an infant whose mother was discharged from hospital only hours after giving birth, the national head of midwives says.

The baby girl died only hours after her mother was discharged from Wellington Hospital on Thursday night after a 30-hour labour which involved an episiotomy – a cut to help childbirth – and consideration of a Caesarean.

A post-mortem has been carried out but the cause of death has not been released. The coroner will consider the results and decide whether an investigation is needed.

The woman's lead maternity carer had reportedly told her she would be better off at home than in the crowded post-natal ward.

But College of Midwives director Karen Guilliland said it was not fair to blame the midwife for the baby's death.

"There's nobody to blame except a system that hasn't got enough beds to allow people to relax into childbirth and to take their decisions in a timely way," she said.


"Nobody has any idea yet why that baby died and yet everybody wants to blame the midwife.

"What we should all be trying to do is making sure that these things don't happen. We all play a part in that."

The midwife would be subject to inquiries by the coroner, the Midwifery Council and the Capital and Coast District Health Board, (CCDHB) as well as doing her own standards review.

She had "miles more" than 10 years' experience in an industry that was desperately short-staffed and had an average age of 48.

Most midwives dealt with four or five births a month but in Wellington the number was higher as the shortage was so severe.

For each woman's pregnancy, birth and after-care, independent midwives received about $2000 before tax, giving an average income of $96,000-$120,000.

Ms Guilliland said midwives were "your mothers and your grandmothers" but faced huge amounts of stress.

"We're looking at one incident but the midwives are the ones that are there on a day-to-day basis knowing that for every bed that is filled, there is a woman waiting for it," she said.

"It is stressful beyond belief to try and fit everybody into the number of beds that there are."

CCDHB last week floated the possibility of giving mothers a $100 grocery voucher if they went home within six hours of birth in a bid to relieve the pressure on beds. The policy – which never got off the ground – was not aimed at first births.

CCDHB Women's Health Services clinical director John Tait said post-natal beds were always available for women having their first baby.

Health Minister David Cunliffe yesterday said he had deep concerns about "wide-ranging systemic issues" at CCDHB but he did not believe women were being bullied out of hospital.

The Health Ministry had spoken to the board following the scrapped voucher plan to ensure no mothers were being sent home against their will.

However Mr Cunliffe was concerned about problems with maternity care and child cancer services at the hospital, as well as several recent and worrying individual cases at the DHB.

Mr Cunliffe warned last month the board would face a major shake-up if it did not improve its performance and yesterday he would not express confidence in the board, instead saying he was seeking urgent advice on options available to him. They included sacking the board and appointing a commissioner, sacking the board's chairwoman or increasing monitoring of the DHB's performance.

The Ministry of Health has set up a Maternity Services Strategic Advisory Group to review the maternity system. The group comprises stakeholders such as midwives, specialists and patient advocates, and is due to report back next June.