Midwife accepts junior standing

A midwife heading the fatal labour of a Huntly woman and her baby accepted during questioning yesterday that at the time she was a junior practitioner in the birthing unit.

At an inquest in Hamilton, the midwife, who has interim name suppression, faced persistent questioning from counsel assisting the coroner Chris Gudsell, who put it to her that she was "out of her depth" as Casey Missy Turama Nathan, 20, gave birth to her son Kymani, on May 21, 2012.

Initially, the midwife responded by saying she and fellow Huntly Birthcare midwife Korina Vaughan "worked as a team whether I was in charge or if she was in charge".

But Gudsell pressed on.

"You didn't take charge of the labour process, you deferred to Ms Vaughan, didn't you?" he said.

"Because of her experience, yes," the midwife replied.

Gudsell told the midwife that was because "your set of skills up until that point in that lead maternity carer role didn't allow you to take anything more than a junior position in this birthing unit on this occasion, didn't it?"

"Yes, I was a junior practitioner," she replied.

However, when asked about Vaughan's evidence that she had said they should carry out the birth at Waikato Hospital and delay breaking the waters, the midwife said she "couldn't recall" Vaughan saying that.

Coroner Garry Evans asked the midwife what could be learnt for other trainee midwives out of this incident, whether students should spend a year working in a hospital before working in the community.

The midwife said it wasn't up to her to offer any comment.

Asked by counsel Paul White, representing her, why Nathan wasn't transferred to Waikato Hospital to give birth, Vaughn said it was the plan until she saw "bulging membranes" before telling the midwife to break the waters.

In questioning from White, Vaughan was adamant neither post-partum haemorrhage nor polyhydramnios were present in Nathan's labour.

"I have seen polyhydramnios, I know what it looks like, I know the volume of water and that it drops onto the floor . . . in this case there was no polyhydramnios."

Earlier in the day the lead maternity carer admitted she had changed her practice around weighing pregnant mothers since the deaths.

In questioning from Gudsell, regarding the use of growth charts, he put it to her that she never did her own height and weight measurements of Nathan for it to be accurate. The midwife replied that most women were aware of their weight.

He asked what use she made of the plottings on the chart if they were not accurate. "Without accurate recordings it's not of great use," the midwife said. "But since that time I no longer take a woman's reported weight to be accurate and I check what her weight is when she's on the scales."

"Is it of any use, if it's not customised?" Gudsell asked.

"No," the midwife replied.

Earlier, the midwife defended her note recording, labelling it "reasonable", after being questioned by Kay Hoult, lawyer for Hayden Tukiri. The midwife said they weren't exhaustive notes due to it being "a very busy time given the context of the situation at the time".

Waikato Times