Midwife's experience criticised
Transcripts of 111 recordings from the day a young Huntly mother died refer to an ambulance officer's concerns about the midwife's lack of knowledge and delays in calling an ambulance.
Meanwhile, the lead maternity carer - who has interim name suppression - has taken the stand on day three of the inquest into the deaths of Casey Missy Turama Nathan, 20, and her son, Kymani, in Hamilton.
The court was played the audio of the midwife's 111 call from for an ambulance in which she stated that she had a pregnant patient who had fainted in labour. The call was made from Huntly Birth Care on May 21, 2012.
In the background, a person can clearly be heard saying "breathe, breathe".
The transcript of the 111 call was entered into evidence by the midwife's lawyer. It recorded the 111 operator stating how those involved in the call needed "a big debrief and a learning curve".
In the transcript, St John Ambulance officer Nigel Dawson replies, "Yes". The operator then states "a lot of it is the midwife at the [Huntly Birth Care]", with Dawson replying: "yeah, she had no idea what was going on".
The pair also spoke of issues around getting an ambulance to Nathan after the 111 operator learned one ambulance had stayed longer at a job without telling the operator.
In her statement to the inquest via audio-visual link, the midwife said Nathan attended eight out of 13 antenatal appointments and had "unreliable contact details".
Nathan told her she was smoking eight to 10 cigarettes per day and the pair discussed the risks of smoking while pregnant, the midwife said.
Nathan attended her first three appointments, the first of which was on November 3, 2011.
At her March appointment, Nathan told her she was down to eight cigarettes a day, she said.
The inquest heard that the first time Nathan's gestation registered in the 90th percentile was on March 20, 2012, and measured 34 centimetres at 32 weeks and five days.
As this was the first measurement in the 90th percentile she was "not suspicious" of polyhydramnios (having too much amniotic fluid in the womb) as the baby was easily palpated, she said.
The midwife said she had just got back from holiday but wanted to be present when Nathan gave birth so attended with a fellow midwife at Huntly Birth Care.
The midwife told how at 10.39am on May 21, "without prior indication or warning Casey suddenly fainted in the pool".
"Hayden [Tukiri - Nathan's partner] jumped into the pool to support Casey in an upright position."
Assistance was called from the two other midwives present and after 30 seconds, Nathan regained consciousness, the midwife said.
Nathan was given oxygen via a facemask, she said.
The midwife said Kymani was born at 11.02am, "pale and limp", however his tone started to improve by 11.12am, as he flexed his arms and legs.
By 12.06pm, Nathan told her, "it feels like I'm leaking down there".
The midwife said she looked and noticed "a gush of around 150 millilitres of blood" come out, before a further 50ml of blood came.
At 12.34pm, the midwife noticed 300ml of blood-stained urine, which she said was abnormal, so she made a phone call to contact the obstetric registrar at Waikato Hospital.