to think this 'midwife' should be struck off

[Northernlurkerisbackatwork]

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.

How can you possibly describe pregnancy and birth as a success if it ends in mother's death?

We all make mistakes and sadly I can imagine that sometimes - mistakes will be made even by a totally competent safe person, i think whats inflamed me - is that its a common mistake - she didnt seem to react quickly enough when the husband said - something is wrong, he had to call her repeatedly - and then - she comes out with the stupid labour comment.

She should be holding her hands up and just saying sorry.

Awful story.
I had a massive PPH after crash section with DC4 and almost died.
Thank God for the skill of the NHS doctors and Midwives attending me.
Agree this was not a low risk pregnancy and home birth unadvisable in this s ituation.

As it happens, she stopped practicing before anyone asked her to, and has been suspended for over a year. As I understand the matter, she is extremely unlikely ever to return to midwifery.

as to the tugging comments -

someone on the other thread described the low traction something or other and that explained perfectly how my MW did my placenta, she really went over my placenta with a fine tooth comb and I would say in no way shape or form was my plancenta tugged at.

My friend however - said for her second the MW did TUG and yank at her cord,,,,and she ended up heamoraging later on with placenta left in and was in intensive care. I then heard about that same mw tugging at other peoples cords and leaving them at deaths door.

the problem is getting people to complain or at least leave feed back!

For her third - she said again, the placenta was delivered properly and gently with the cord traction thing.

I do think people can differentiate between tugging too much and proper cord traction.

what a comment to make, I do hope it was in some sort of context that makes it a bit better (can't think what though!). Such a sad case

I worry that this case won't help with the plans to totally get rid of independant midwives next year though! not that I have or would ever choose one but the choice is very close to being taken away. There are definitely a few bad eggs in independant midwifery, but getting rid of them all is not best for women

I'm not excusing the midwife but what possessed that woman to have a hie birth given her past history. I'm not sure I buy into the 'brainwashing' idea.

Home birth

i buy it, my NHS antenatal class was cancelled and we were given a free one with an indi MW

a good percentage of the women had complications which meant they were already booked in for consultant care, she told EVERYONE that they could and should choose a water birth at home (as she passed her card around ) and had nothing but horror stories and intervention cascades to say about both hospitals and all NHS staff

One woman from the class's child was quite ill because she refused transter out of the MLU for ages when things became complicated because she had become TERRIFIED of hospital birth after the classes

I complained to my NHS MW, she was shocked and later contacted me to assure me that it had been taken higher she would never be hired for subsidised antenatal classes again.. but she is still practicing!

I am still very much in support of not banning indi MWs though! Like I say: bad eggs!

I gave birth in that trust. Fantastic hospital. I wasn't given the option of hb at all.

Previous pph, csection like this lady. I was high risk. Go against that at my peril.

An over zealous mw here I think for her own selfish gains. As the woman was down to give birth at Basingstoke. The other hospital. She had her baby 2 months after me. When I lived there you were given 2 choices. So looks like she was booked in on the NHS for a hospital birth.

"She had a lovely birth" is such a chilling comment to make.

I think a lot of IMs only get work because so many women have shitty experiences giving birth in hospitals and just want "a lovely birth". A lot of IMs take on high risk women that the NHS wouldn't support giving birth at home. I think maybe that explains why she said that. Providing a good birth experience is her raison d'etre and it sounds like she's lost touch with what REALLY matters in the end. Live mother trumps "good birth".

'As it happens, she stopped practicing before anyone asked her to, and has been suspended for over a year. As I understand the matter, she is extremely unlikely ever to return to midwifery'

From what I've read she's extremely unlikely to have the opportunity to return.

I can't understand why some posters are defending this woman tbh. The undisputed fact is that she missed seeing a large section of placenta had been retained.

It's easy for people who haven't seen the placenta to say how can you not notice 30% of it is missing. I'd like to thnk it's difficult and that I never would.

But placentas aren't all the same size. You look for any obvious missing chunks, you look for rough edges, vessels that lead to nowhere making you think a whole chunk is missing, etc. but in theory it would be possible to have a bit missing where there is no obvious chunk missing.

Though I do believe in this case a consultant has seen the placenta and said it was obvious. Though I'm unsure if that's an expert witness for the prosecution or just a local consultant from the hospital. If its the former I'd take it with a pinch of salt.

If the midwife needs striking off she will me. The nmc are generally very decisive about these things. But she deserves a fair hearing.

her responses to the bereaved husband also sound almost nasty, I hope they also have been taken out of context, for e.g. instead of replying with simply her version of the facts she more or less said "I'm not an idiot" to his claim that she checked the placenta in poor light

perhaps the unreported bits in between contain lots of sadness that the woman died and compassion to the family - I really hope so, but there's none in the quotes

Viva - both the hospital consultant and a midwife supervisor engaged by the NMC have said at the inquest that it was obvious to them.

As a midwife what's your opinion of her 'lovely birth comment'?

The lovely birth comment is unbelievable. She didn't have a lovely birth, she died!

I don't know what to think about homebirth anymore to be honest.. I like to think of myself as open minded and I can see that if a woman is very frightened in hospital that may make things more difficult..

Having said that I nearly died 12 weeks ago because my "straightforward" elective c section actually uncovered a completely undiagnosed placenta previa (I had no symptoms whatsoever and had 3 scans and there was nothing on those) and if I had opted for the home birth everyone kept suggesting that I had (second baby, no complications known etc) then I would have been dead - or my lovely 12 week old ds would be. There was actually a heart wrenching story like this on here recently - the woman started as a home birth and was then transferred to hospital - and her baby died. My heart went out to her - it was the same story as mine but with a very different ending.

"It's easy for people who haven't seen the placenta to say how can you not notice 30% of it is missing. I'd like to thnk it's difficult and that I never would."

I'm guessing you are a midwife as you speak with some authority, but as sometimes who hasn't done Obs & Gynae since I was a medical student, I think I'd be pretty able to tell if 30% of a placenta is missing. It's all about how it looks, how the membranes look - don't think it is that hard.

"Though I do believe in this case a consultant has seen the placenta and said it was obvious. Though I'm unsure if that's an expert witness for the prosecution or just a local consultant from the hospital. If its the former I'd take it with a pinch of salt."

A top consultant said it would be obvious to her, I really dont know how many people with how much experience would need to comment on it - for anyone to say - yes - it was bloody obvious!

why defend the in defensible.

For 99% of placentas youd be right. But I was more thinking about a succenturiate lobe. Never say never. I've seen experienced registrars say a placenta was complete and then we go to theatre for EUA due to an ongoing pph and a big bit of placenta is pulled out.

Dr Helen Allott, a consultant gynaecologist, expressed disbelief Mrs Teague had not been taken to hospital earlier.

"In my opinion had the placenta been examined in good light in a conventional manner it would have been apparent that a large piece was missing," she said.

"I have looked at thousands of placentas and this placenta, I must say, I was quite shocked.

"I was very clear in my mind that a very large piece was missing."

This lady was actually " shocked" by the placenta.

What a terrible story.

I'm interested in one of the mw's comments (as reported) further down; that she felt the hospital wouldn't have accepted her request for transfer. That sounds to me as if at some stage the relationship between her and the hospital had seriously broken down. Why?

The only independent midwife I ever talked to also worked some shifts for the local NHS and maintained good relations with the team. Nobody can work as a lone wolf, not in healthcare.

It sounds like this lady actually saw the placenta herself.

It does make you wonder if she never actually checked it.

I can't imagine any hospital wouldn't accept a transfer, that sounds like bollocks. If a midwife rings up and says they have someone they're concerned about then they go in, politics don't come into it.

And if the relationship between the midwife and the hospital is that bad that she thinks that then she shouldn't be agreeing to care for women!