Monday, June 16, 2008

Irish hospitals suspend waterbirths after aspiration death

According to the Irish Independent:
Water births have been suspended in maternity hospitals and units following the death of a baby boy who was delivered in a birthing pool.

An inquest heard last week how baby Harry Eccles ... died three days after breathing in water during his birth in a pool at Cavan General Hospital in February 2006.

A spokesperson for Cavan and Drogheda maternity units said the birthing pool service was suspended for births following the incident and was now only available for pain relief.

Cork University Maternity Hospital, which also has a birthing pool, said it would not be using it for births until after the outcome of a national review on water births...
A newspaper account of the inquest details how the drowning occurred and the findings of the pathologist:
The inquest heard that Harry's death was due to "acute near drowning" after he inhaled water from the birthing pool. A 'near drowning' means that the victim survives temporarily, whether for a matter of hours or days, but ultimately dies. The baby's brain was also starved of oxygen.

Pathologist Dr Peter Kelehan said that it is well known that babies can inhale amniotic fluid while in the womb but that this does not cause any damage to the infant.

He said the changes found in baby Harry's body would not support the theory that he had inhaled amniotic fluids and instead concluded that he had inhaled fresh water during the delivery process.

Instinctively babies should not breathe until they break the surface of the water and meet the air. Instead, they are supposed to continue to be supplied with oxygen through the umbilical cord until they breathe on their own. However, studies have shown that if they don'tget enough oxygen during birth they may gasp for air, running the risk of inhaling water...

"Then the shoulders were born. It was around 60 to 90 seconds after the head before the shoulders were born. I then assisted the baby to the surface of the water," said the midwife.

However, as the baby reached the surface it immediately became clear that something was wrong...

Harry's grandmother, Siobhan Eccles, said that after the baby's head was born, her daughter waited for the next contraction, which never came.

She said when there were no further contractions, Ms Loughran pushed on her daughter's stomach, causing her to "let out a scream".

The midwife denied that she had pushed on Ms Eccles' stomach, but said she had simply put her hands down into the pool to make sure the baby didn't drop to the bottom.
It sounds as though the delivery of the shoulders was slightly delayed, giving the baby plenty of time to inhale a large amount of freshwater. The baby inhaled so much freshwater that when it was absorbed by the lungs, it lowered the concentration of electrolytes in the baby's bloodstream to a level leading to death.

The legal case was further complicated by the fact that the parents were told that the baby died of a genetic disorder and did not learn about the pathologist's finding of drowning until they attended the inquest.
Barrister for the Eccles family, Sara Antoniotti yesterday told the Coroner that the Eccles family were completely unaware of the pathologist's findings that little Harry died as result of drowning, when many of the people who assisted in his birth were giving evidence, (including midwife, Elisabeth Loughran) at an adjourned inquest on May 8.

As a result the family did not ask the questions that they would have asked had they been aware of the pathologist's findings and wanted an opportunity to ask those questions, the court heard.

"The Eccles family knew nothing about a proposed drowning in a birthing pool - his mother Gina had thought he died as a result of a genetic disorder.

"You can imagine the horror and shock for the family when they discovered this," said Ms Antoniotti.

"This is a most unusual case.

"It's very traumatic for the family and needs to be investigated further.

"It's not only to allay the fears of the family, but the fears of the general public," she said.
It seems that the hospital was aware of its culpability and hoped to hide it by telling the parents that the baby died from an unpreventable genetic disorder.

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