A young mother who developed complications during a home birth died after a midwife lacked the confidence to inject her with fluids, an inquest was told.


There was also a delay in giving Joanne Whale treatment that could have saved her life in hospital after another midwife failed to pass on information to the doctors there.


Dr Peter Dean, the Greater Suffolk Coroner, said that lessons must be learnt from her death and that women should be made more aware of the dangers of home births. He also demanded better communication between midwives and doctors.


Miss Whale, 23, gave birth to a healthy boy at home in Ipswich last September. But she died hours later after a severe haemorrhage.



When Ms Whale began to lose blood she needed an injection of fluids. Julie Bates, a midwife, said that she had been trained in the process but had never had to use it. “I’ve got the theoretical knowledge but not the practical knowledge,” she said. “I felt uncomfortable having to do that in this situation.” She added: “Knowing the ambulance was only a few minutes away I thought it was better to leave it for the proper paramedics.”



http://www.timesonline.co.uk/tol/new...cle3934513.ece

[Cb]

What a negative comment made by the coroner. It wasn't the dangers of home birth that lead to the unfortunate death of this mother but the lack of experience of the midwife and the lack of ciommunication between medical staff in hospital.

Statements like that are not good for advocates of home birth.

[midwifemissy]

That is so very sad, it isn't much good having the theoretical knowledge if you haven't got the confidence to put them into practice when the skills are needed.

I agree the coronors comments are very negative, but then I have no faith in them anyway so....

[Shoshana]

How very sad.

I commented on another thread recently that I think midwives should gain confidence and experience in the hospital setting, before going out in community. It is for just such a situation that the midwife needs to have the experience behind her.

NICE guideline have made it clear that whilst homebirth is safe in the majority of cases, when problems occur the consequences can be far more severe, for both mother and baby, due to the distance and time it takes to get medical help.

[Spunky Cupkake]

yes i agree i was told you have to have a least 2 years experience in a hospital afetr quallifying before being able to be a community midwife x

[kitten]

Its sad but I disagree that home births are dangerous (everything has it risks). I will quite happily have my next baby at home. I agree that a midwife needs the experience of a labour ward before going it alone

[sassy]

How sad I feel that in this case it wasn't the home birth that was unsafe, but the self confidence of the midwife. I'm not blaming her totally as I do agree that they should have more experience before going out into community.

I know our trust won't allow a midwife with less than 2 years experience in the hospital to go out into the community setting.

Maybe if the coroner did his research too, he would realise that homebirths are safer than hospital births for woman and baby. And sadly women do die, whether in hospital or at home

[smwife]

Originally Posted by coffeebean What a negative comment made by the coroner. It wasn't the dangers of home birth that lead to the unfortunate death of this mother but the lack of experience of the midwife and the lack of ciommunication between medical staff in hospital. Statements like that are not good for advocates of home birth.

Well said, that was exactly my thoughts. How sad for all concerned. Iwonder what will happen to the midwife?

Off to read the article

[smwife]

OMG, looks very bad for the midwife, would be interested to hear excatly what happened. Wonder why she was not handed over properly?

[wannabe]

Think I would want to know a great deal more about the cause of the uterine inversion and subsequent bleeding, what was done prior to transfer, the details of the handover (if any), communication within the hospital team as well as between homebirth midwives and hospital, how long the woman was in the hospital and undergoing what (if any) treatment.

Clearly, if she had been in hospital, uterine inversion would have resulted in immediate obstetric review and action. That didn't happen in this case because the obstetricians were under the impression that the woman had a retained placenta. However, if she was in the hospital for any length of time, the fact that she was continuing to bleed to death in the hospital should have been apparent - regardless of whether they had her down as an inversion or retained placenta - so what was done once in the hospital (and over what time period) is also important.

The CEMACH report will make interesting reading.