Tuesday, May 13, 2008

Mother dies at homebirth

It was bound to happen, but it is a horrifying tragedy nonetheless. A British paper reports the death of a mother from uterine inversion, compounded by midwife incompetence, at a homebirth:
Joanne Whale, 23, from Ipswich, suffered a "massive haemorrhage" because of complications as she gave birth to a healthy baby on September 10 last year.

She was rushed to hospital by paramedics, but an inquest heard today how doctors were not informed of the exact nature of her condition - leading to a delay in getting her into the operating theatre...

Giving evidence at the hearing, held at Ipswich Crown Court, midwife Sarah Hall admitted she did not pass on information that Miss Whale had suffered an "inverted uterus" during labour.
The midwife was also incapable of performing the most basic resuscitation maneuver, insertion of an IV:
The inquest also heard midwives supervising the home birth - along with the technician paramedic who was first to arrive following the 999 call - were not capable of injecting fluids into Miss Whale as she started to lose blood, a procedure known as canulation.

Midwife Julie Bates said although she was trained in the process, she had never been called to put it into practice.

"I've got the theoretical knowledge but not the practical knowledge," she told the inquest. "I felt uncomfortable having to do that in this situation..."
The coroner expressed suprise that the midwife did not know how to insert an IV:
He also said the public needed to be better informed about the possible dangers of home births and communication between healthcare professionals improved.

"I think we can see those areas where lessons need to be learned," he said. "It does worry me a lot that mothers are giving birth in the community and the first line of call is the midwife who might not be able to get fluid into her in those crucial early moments. Clearly that needs to be addressed..."
This is exactly why homebirth is never going to be as safe as hospital birth. When a life threatening emergency occurs at home, the midwife is incapable of managing it or even instituting appropriate resuscitation. Usually it is the baby who dies, but that's because neonatal complications are far more common than maternal complications. When a life threatening maternal complication occurs, midwives can do nothing.


0 Old Comments: