Delivery by new midwives 'dangerous'

BY EMILY WATT
Last updated 05:00 17/12/2009

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A nurse whose baby died during birth at Kenepuru Hospital says allowing midwives to deliver babies straight after they graduate is dangerous.

The Porirua mother's baby died after a junior midwife failed to recognise he was being born feet first and an experienced midwife refused the junior woman's requests for help, saying "You're doing fine".

The mother, a registered nurse, said the College of Midwives should have better monitoring of graduates.

"Without any experience, they are practising on people's lives. It's not safe."

The baby's death prompted national concern over maternity services, and the government at the time promised a review of Wellington services.

The health and disability commissioner issued his report yesterday, in which he faulted the senior midwife for refusing to help, but said the junior midwife's actions were "appropriate in the circumstances".

The College of Midwives said further supervision was unnecessary and stood by the midwives' actions.

This is the first time the mother has spoken about the case.

She said the fact this tragedy could happen despite her own medical knowledge showed the powerlessness of patients and the need for proper training and supervision of medical professionals.

The woman went into labour on June 21 last year and was taken to Kenepuru Hospital for a water birth.

The midwife, a recent graduate, failed to diagnose the breech position despite performing three examinations. Breech births are difficult to diagnose and an earlier scan had shown the baby was in the correct position. She was concerned when she felt small bumps and asked her mentor, a senior midwife, to examine the mother. The senior midwife refused and told her "You're doing fine".

The baby came out buttock and foot first and initially kicked strongly as he was trapped half-way out for 20 minutes. His kicks became weaker as he suffocated.

"I pushed him out, he didn't cry," the mother said. "He was very floppy. [The midwife] put him on my chest and it took her two to three minutes to realise he wasn't breathing."

The midwives tried to resuscitate the baby and medical help was called, but it was too late.

Although faulting the senior midwife for failing to intervene, the health and disability commissioner said even if she had done so, the baby would not have survived.

The mother said the commissioner's report was weak. She did not blame the junior midwife, but allowing newly graduated midwives to work alone was setting them up to fail.

"You can't blame someone for being negligent if she doesn't know what she's doing."

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The mother wanted the College of Midwives to act. "Being negligent as a midwife is a devious error because you are most likely to put at least two lives in jeopardy."

A review by Capital and Coast District Health Board last year criticised the communication between the midwives and said the junior woman had "an opportunity" to identify the breech during three examinations.

College of Midwives chief Karen Guilliland said the midwives did everything expected of them and the reports found they had not contributed to or caused the baby's death.

- The Dominion Post

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