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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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Original poster

to think this 'midwife' should be struck off

127 replies

Northernlurkerisbackatwork · 06/09/2012 13:43

I have been reading an account of an inquest in to the death of a woman who bled to death following a homebirth here

I have no quarrel with the decision to have a home birth. The mother should have been safe enough in competent hands. I cannot believe that a competent midwife would miss that so large a part of the placenta was missing. If there was any doubt about that - and she clearly noticed parts were missing she should have stayed and monitored the mothers condition. In another account I've read it mentions that she was doing CPR on the bed instead of moving the mother to the floor where it would have been most effective.

However it is her comment to the inquest '?Claire had a great pregnancy, she had a really lovely spontaneous birth at home and I hope Simon (the husband) in time will remember that.? What? Remember that shortly before his wife suffered massive blood loss and cardiac arrest she had a normal delivery? And thus be all comforted? Who is she trying to kid. The lack of insight and empathy displayed is chilling. I earnestly hope she isn't permitted to attend another pregnant woman!

Of course this case will be used to hammer home birth - when the issue is in fact a negligent care-giver.

OP posts:

elizaregina · 06/09/2012 16:17

sorry,

option of elc which she did say at points she wanted...

RuleBritannia · 06/09/2012 16:34

Both my children were born at home because there were not enough beds at the local hospital.

One thing I remember about the end part of the births was feeling the midwives pummelling on my stomach to move the placenta - which then slid out by itself. I don't think I'd like to have it pulled out. It would feel like having teeth pulled. How ghastly for the mother.

Didn't this midwife pummel the stomach?

WilsonFrickett · 06/09/2012 16:40

If you've had a traumatic birth (which it sounds like this poor woman's first pg was) then it can be very easy to mentally over-ride advice /warnings and insist on a HB. I know I wouldn't want to set foot in a maternity ward ever again, for instance.

I do wonder if she hired this woman because she told her what she wanted to hear. Even that in itself is disgusting. That poor wee family

WizardofOs · 06/09/2012 17:11

It is quite common, when something traumatic and awful happens, to distance oneself from the event and place the blame squarely and completly on someone else or an outside factor. Hence, perhaps, the claim of being brainwashed. It is a very uncomfortable feeling to think that you have had a part to play in a decision that had such a bad outcome.

This does not mean the MW is not at fault but I do find the allergation that she brainwashed this woman into wanting a HB the hardest part to believe.

This MW performed a managed third stage with controlled cord traction..that was the correct and lowest risk way in the circumstances. The question is whether she tugged the cord instead of gently applying traction. Tis his word against hers. Also why did she not notice such a lot of the placenta was left behind?

CakeBump · 06/09/2012 17:19

Same here in Germany MyLastDuchess

I'll be having DC1 at home in December, if everything goes well. It's seen as very normal here even though no drugs are available for a home birth. In fact my midwife was shocked that gas and air are still used in the UK and said it is seen as very "last century" here.

Even so, if there was any risk at all I would be moved to hospital straight away and I have certainly spent time choosing my midwife as one with fantastic credentials and experience.

That poor family.

elizaregina · 06/09/2012 17:19

Wizard,

so the husband was lying> he did research and found out you dont tug the cord - and he made that up? And also he and his wife were 100% behind the HB including all risks?

I dont see why he would lie about it?

He desribed in a court of law how she tugged on the cord. this account shocked the consulant there.

And concurrent with this - a large piece of placenta was left in.

Her comment about the lady having a " lovely spontenous labour" after this woman has now died sounds like some one in cloud cookoo land to me.

elizaregina · 06/09/2012 17:21

I would simpy urge anyone in HB or hospital birth to stress on thier birth plan to please check the bloody planceta - as I have said before - Its really common round where I am - and that was also in surgey too!

DuelingFanjo · 06/09/2012 17:27

I think itcomplicates things to say she was 'brainwashed' into a home birth. It's not the home birth that was the problem but the midwife. I can totally understand her husband is completely devastated by this and the midwife is clearly to blame but it's not the home birth's fault.

CakeBump · 06/09/2012 17:31

It strikes me that overseeing 96 home birth in a career spanning 20 years is nothing

My midwife reckons she does about 100 home births a year....

elizaregina · 06/09/2012 17:35

The consulant said with the ladies past history of pph, she perhaps shouldnt have had a HB. So surely in this case she shouldnt? She should have been in hospital?

Being at home put her at much greater risk?

With the added risk of the MW in charge?

It strikes me that overseeing 96 home birth in a career spanning 20 years is nothing

Doesnt the consultant say she herself has seen thousands of placentas?

WizardofOs · 06/09/2012 17:40

Elizaregina - no I didn't say he was not telling the truth. I am sure he is telling the truth as he sees it - as we all do. And indeed she may have actually tugged the cord and she may well have handled the third stage incompetently. I would rather wait for the outcome of the inquest and investigation before making too many judgements though.

dontcallmehon · 06/09/2012 17:43

My midwives used cord traction to get the placenta out during my home birth. It had been an hour and a half. Reading this I'm wondering if they should have done this, though obviously in my case everything was fine.

CakeBump · 06/09/2012 17:43

eliza what I think I was getting at is that she may have been present at lots of hospital births, and therefore seen lots of placentas, but she doesn't exactly seem an expert on home birth.

Now I'm only expecting DC1 and know very little about the whole process, hospital vs home etc, but it just struck me that she's hardly the expert on home births, having done 96 in 20 years....

Snowsquonk · 06/09/2012 17:44

Please don't forget that you're reading reporters interpretations of what was said at the inquest - it's all out of context and being spun.

The husband saying his wife was brainwashed could be his grief-stoked reaction - she may have very much wanted a home birth, maybe he didn't ? He says tugging on the cord - he's never seen controlled cord traction before.

The midwife's comments on the pregnancy and spontaneous labour and birth could have been part of a much longer explanation of what happened but have been plucked out and used to make her appear a heartless cow.

This is trial by news reports and I feel very sorry - both for the family AND for the midwife. Bad things happen - at home and in hospital and often some poor health professional is hung out to dry.

This case should be left for the Nursing and Midwifery council to look at and decide whether the midwife is fit to practise.

daisydoodoo · 06/09/2012 17:56

There is a difference between controlled cord traction and tugging on the cord.

Pummeling of the uterus should not happen though. I think some midwives who aren't very well practiced in a physiological third stage sometimes panic and get edgy about the amount of time it can take.

FreddieMercuryforQueen · 06/09/2012 18:03

The usual 'active management' of the delivery of the placenta does involve what may appear to the untrained eye as 'tugging', I could certainly be accused of 'tugging' on cords when trying to check for separation and virtually no doctors ever even wait for signs of separation before giving the cords a good 'tug'.

FreddieMercuryforQueen · 06/09/2012 18:04

There is a difference Daisy but would a laypersons know that difference? Pulling is pulling is pulling to some people?

BoreOfWhabylon · 06/09/2012 18:13

Excellent post by Snowsquonk. I agree completely.

Original poster

Northernlurkerisbackatwork · 06/09/2012 18:20

I had (successful) controlled cord traction with dd3 when I bled heavily right after delivery. I agree that interpretations of that action may vary. I don't think missing that 1/3 of the placenta has been retained is anything other than negligent though and her incredible crass comment is terrible.

The 'brainwashing' - I think that's emotive language and I don't place much emphasis on that. I'm sure the independant midwife was pro-homebirth - where she would have complete control - and that she believed her controlling the birth would be to the benefit of the mother. Nobody goes to work thinking 'today I will kill a healthy young mother'. However from the evidence disclosed so far I think the care that she gave was suspect and I don't think she can face up to that at all. I agree - this isn't about homeborth, it's about poor care after the birth and that could have happened in hospital. The only difference in hospital is that the mother would have been closer to the resources needed for resus.

I certainly don't think it's the case that this woman should have been 'told' not to have a homebirth. That was her choice and she was I'm sure aware of the risks that are wellknown. The risk she didn't know about was that she was in the hands of somebody who would make mistakes.

OP posts:

TheQueenOfDiamonds · 06/09/2012 19:31

I have to question the capabilities of someone who doesn't notice such a large part of the placenta missing.

I'm not sure about the 'agressive' placenta delivery though - I thought it always looked worse than what it actually is, And reading his description, i thought the same as what the midwife later said - That if she pulled that hard it would have snapped.

Although i imagine the nature of the events mean he is unable to recall each action and look at it rationally, Which is forgivable under the circumstances.

RaisingEmbers · 06/09/2012 19:33

I need a thumbs up for Snowsquonk

TwelveLeggedWalk · 06/09/2012 19:43

Such a sad story, but I just can't see how the couple got into that situation. I had a crash CS with twins and heavy bloodloss afterwards, and my midwife basically told me if I ever got pregnant again to move into labour ward from the third trimester! There is no way they or anyone else involved in my care would countenance an HB for any future deliveries for me, something I am really quite sad about but entirely see the logic of. How did the medical staff involved in her pregnancy not flag up that this was a high-risk decision?

AlfalfaMum · 06/09/2012 19:47

I agree she should be struck off.
I'm a big fan of homebirth having had two, but this case does make me think there is more risk of harm from one incompetent individual than there would be in a hospital or birthing centre, where other members of staff would be there to say something is wrong/not being done the right way.
I'm amazed she's not simply saying "Sorry, I made a mistake, I was tired and my judgement was off" instead of all this "lovely birth" nonsense. Maybe she has said that too but hasn't been quoted?

Bluegingham · 06/09/2012 19:52

The other thread with the midwife's mate commenting

elizaregina · 06/09/2012 20:00

"I'm amazed she's not simply saying "Sorry, I made a mistake, I was tired and my judgement was off" instead of all this "lovely birth" nonsense. Maybe she has said that too but hasn't been quoted? "

I agree and this comment certianly fits in with the husbands brainwashing comment - someone has died has she still hasnt got it yet!!!! STILL insisting the mum had a lolvey spontaneous birth.

I thikn its safe to say there is a hardcore of nutters even on mumsnet who just blindly insist that HB is great under any circs..and that all ills come from hospital - so this mw doesnt surprise me.

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