Don't go it alone, midwives told
A Motueka mother whose newborn baby died following complications after being delivered at home by a midwife is satisfied with a coroner's recommendation aimed at preventing a similar tragedy.
Joanne Healey said after the release yesterday of coroner Ian Smith's report into the death of her baby, Breeze Marshall, in 2006 that while she did not blame the midwife she was reconciled by the findings that midwives should not operate in isolation, and backup or a planned hospital alternative must be available during home births.
Mr Smith said in his report that Breeze Marshall was pronounced dead at Nelson Hospital. He died from "extreme complications" after he was born at home on October 14, 2006.
Mr Smith said he was concerned there wasn't another midwife available to support the lead midwife during Breeze's birth.
"It is not good practice to go it alone. Motueka is not an isolated area – it is within 40 minutes of Nelson city," he said.
Ms Healey believed the outcome might have been different had she delivered her baby – her third child – in hospital as opposed to the home birth she opted for.
She also felt the outcome might have been different if the contrast in pain she experienced during delivery had been acknowledged sooner.
The baby was the first of Ms Healey and her partner Tawhiwhi Marshall, but Ms Healey had previously given birth to two other children.
She contacted midwife Camille Matthews early on in her pregnancy, and was seen regularly throughout the trouble-free term. Ms Matthews, a registered midwife for 25 years, who had been practising exclusively as a home-birth midwife since about 1997, had also delivered Ms Healey's second child.
Mr Smith said in his report that labour progressed smoothly, until an hour before Breeze was born when Ms Healey told Ms Matthews and her partner that the pain "did not feel right".
Ms Matthews responded that it was "just part of the labour process". She monitored the baby's heart rate a couple of times prior to delivery, and everything appeared normal, Mr Smith said.
The baby was not breathing when born, at which point the midwife began CPR and asked a family member to call an ambulance. A rescue helicopter was then called, and the baby was flown to Nelson Hospital, where he was pronounced dead.
The family was told that Breeze died of "severe intrapartum asphyxia", which occurred in hospital births as well.
"Because of the high mortality rate, it cannot be said that the outcome for baby Breeze would have been any different if the birth had been at hospital," Mr Smith said.
A postmortem report found that death was unlikely to be as a result of cord prolapse alone, but more likely as a consequence of cord compression that had not been clinically recognised.
The baby's father, Mr Marshall, said in the coroner's report he had no concerns about how Ms Matthews carried out her duties, with the exception that he believed neither himself or Ms Healey were counselled about the potential dangers of a home birth. He believed this should be mandatory for parents considering either home birth or hospital birth.
Mr Smith said it was Ms Matthews' standard practice to inform every woman at the booking visit that by choosing her as the lead maternity carer they would be choosing a home birth as she did not have any contracts to provide midwifery services in the hospitals.
He also recommended midwives advise women and their partners who were planning home births about any risks.
NZ College of Midwives' Nelson-Marlborough chairwoman Andrea Vincent said the college already recognised the need to have a second midwife present during a home birth. "There's nothing new in that," she said.
Ms Healey and Mr Marshall have since had another child, with another due in February.
Ms Matthews ceased practising in 2007.
The Nelson Mail